title: [Conductive disorders following open-heart valvular surgery. Concerning 230 operated patients].
abstract: OBJECTIVE
  Conductive disorders following open-heart valvular surgery represent serious complications that may require definitive pacemaker implantation. The natural history of these troubles is not well established thus, controversy persist concerning the timing of pacemaker implantation. In this study we identify the predictive factors of permanent conductive disorders in order to assess the optimal time of pacing.
  
  
  RESULTS
  Two hundred thirty valvular replacements were done between 1993 and 2003. The mean age of our patients was 42 +/- 13.4 years. Rheumatic valvulopathies accounted for 76% of cases, with 54% of multiple valvulopathies. Twenty-two patients (9,5%) had an early postoperative conductive disorder, 9 of them (4%) were definitively implanted after a mean delay of 31.8 days. Preoperative bifascicular bloc and early installation of postoperative high-grade conduction disturbances and its persistence for more than 48 hours are significantly associated with permanent postoperative conductive disorders (respectively P = 0.04 and = 0.03). Aortic valve surgery and infective endocarditis were more frequent in the implanted group but the difference was not significant.
  
  
  CONCLUSIONS
  After open-heart valvular surgery; predictive factors of definitive conductive troubles justify an earlier pacemaker implantation. This attitude may accelerate the hospital discharge and decrease the disease cost effectiveness.
authors.affiliation: Service de cardiologie, hôpital Habib-Thameur, 8, rue Aly-Ben-Aved, CP 1008 Montfleury, Tunis, Tunisie. youssef.benameur@rns.tn
authors.forename: Y
authors.initials: Y
authors.lastname: Ben Ameur
authors.forename: F
authors.initials: F
authors.lastname: Baraket
authors.forename: S
authors.initials: S
authors.lastname: Longo
authors.forename: N
authors.initials: N
authors.lastname: Annabi
authors.forename: L
authors.initials: L
authors.lastname: Bouraoui
authors.forename: W
authors.initials: W
authors.lastname: Mokni
authors.forename: K
authors.initials: K
authors.lastname: Battikh
authors.forename: M L
authors.initials: ML
authors.lastname: Slimane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002404:Catheterization / Q000009:adverse effects; D004697:Endocarditis, Bacterial / Q000209:etiology; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D005544:Forecasting; D006327:Heart Block / Q000150:complications; D006349:Heart Valve Diseases / Q000601:surgery / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010138:Pacemaker, Artificial; D011183:Postoperative Complications; D012214:Rheumatic Heart Disease / Q000601:surgery; D013997:Time Factors