[Atrioventricular conduction disturbances after CoreValve(®) aortic prosthesis implantation. Predictive role of transesophageal echocardiography].
Atrioventricular conduction disorders can appear after the implantation of percutaneous aortic CoreValve(®) prostheses in patients requiring permanent pacemakers (40%-45% of these patients). The aim of our study was to detect if 2- or 3-dimensional echocardiographic variables could predict the appearance of atrioventricular conduction disorders. For this purpose, the relationship of the prosthesis with the interventricular septum was studied in 26 consecutive patients. Twelve patients (46.1%) developed atrioventricular conduction disorders. A prosthetic penetration >12 mm in the left ventricular outflow tract and a contact surface >90% between the interventricular septum and the stent of the prosthesis in diastole were strongly associated with the appearance of conduction disturbances (87.5%; P=.034). The percentage of the prosthetic stent in contact with the interventricular septum in end diastole was the only independent predictor of atrioventricular conduction disorders (odds ratio=1.12; 95% confidence interval, 1.01-1.25; P=.03). The results suggest that a higher implantation of the prosthesis and a reduced stent length might decrease the incidence of this complication.
Unidad de Imagen Cardiovascular, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España.
Carlos
C
Almería Valera
Alberto
A
de Agustín Loeches
Rosa Ana
RA
Hernández-Antolín
Eulogio
E
García Fernández
Leopoldo
L
Pérez de Isla
Cristina
C
Fernández Pérez
Carlos
C
Macaya Miguel
Jose Luis
JL
Zamorano Gómez
D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001283:Atrioventricular Node / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal; D005260:Female; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006334:Heart Function Tests; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D015607:Stents