title: Late conduction defects following aortic valve replacement.
abstract: OBJECTIVE
  The study aim was to determine the incidence and clinical significance of late cardiac conduction defects (CD) after aortic valve replacement (AVR).
  
  
  METHODS
  An analysis was made of 100 consecutive cases after AVR in a prospective outpatient evaluation program.
  
  
  RESULTS
  The perioperative (30-day) mortality rate was 5%, and incidence of perioperative pacemaker implantation 3%. Among patients, 19% had CDs before surgery; a normal ECG was present during all periods in 45% of patients. The most frequent perioperative CD was left anterior hemiblock (LAHB; n = 8), and the most frequent late CD was left bundle branch block (LBBB; n = 8). Overall, 13.7% of operative survivors with normal preoperative and perioperative ECGs developed late CDs; one patient (1%) required pacemaker implantation 82 months after AVR. A further three patients (3%) had worsening of pre-existent CDs. Late CDs occurred over a wide time range (3 to 102 months) after surgery.
  
  
  CONCLUSIONS
  There is an important incidence of CDs that occur late after AVR, even if the perioperative ECGs are normal; however, a need for late pacemaker implantation is rare. As CDs may occur at any time after surgery, regular follow up with precise evaluation of ECGs is called for.
authors.affiliation: Department of Surgery, University Hospital, Basel, Switzerland.
authors.forename: J M
authors.initials: JM
authors.lastname: Habicht
authors.forename: P
authors.initials: P
authors.lastname: Scherr
authors.forename: H R
authors.initials: HR
authors.lastname: Zerkowski
authors.forename: A
authors.initials: A
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006327:Heart Block / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies