title: Postoperative conduction disorders after implantation of the self-expandable sutureless Perceval S bioprosthesis.
abstract: OBJECTIVE
  Minimally invasive techniques for aortic valve replacement (AVR) have been developed as an alternative to conventional AVR for patients with high operative risk. Yet, these techniques are still associated with an increased risk of postoperative conduction disorders. The study aim was to identify the incidence and fate of postoperative conduction disorders in patients undergoing sutureless (SU) AVR with the Perceval S bioprosthesis.
  
  
  METHODS
  In this observational study, patients who underwent SU AVR with the Perceval S prosthesis at the Catharina Hospital, Eindhoven, were analyzed. Electrocardiograms (ECGs) recorded at baseline, within 24 h postoperatively, before hospital discharge and at follow up were collected by reviewing patients' records. The ECGs were analyzed by two independent investigators to record QRS-duration and conduction disorders.
  
  
  RESULTS
  All patients (n = 31) who underwent implantation of the Perceval S bioprosthesis between September 2010 and September 2012 were included. At baseline, three patients (9.7%) had preexisting left bundle branch block (LBBB), and one patient (3.2%) had a permanent pacemaker (PPM). New-onset LBBB developed in 11 patients (39.3%), and was transient in three patients (10.7%). Postoperatively, four patients (13.3%) required PPM implantation because of total atrioventricular block; all of these patients had either pre-existing LBBB (n = 1) or new LBBB (n = 3).
  
  
  CONCLUSIONS
  Sutureless AVR with the Perceval S bioprosthesis was frequently complicated by new LBBB, which was persistent in the majority of patients. A relatively high incidence of postoperative PPM implantation was also observed.
authors.forename: Astrid G M
authors.initials: AG
authors.lastname: van Boxtel
authors.forename: Patrick
authors.initials: P
authors.lastname: Houthuizen
authors.forename: Mohamed A Soliman
authors.initials: MA
authors.lastname: Hamad
authors.forename: Jelena
authors.initials: J
authors.lastname: Sjatskig
authors.forename: Erwin
authors.initials: E
authors.lastname: Tan
authors.forename: Frits W
authors.initials: FW
authors.lastname: Prinzen
authors.forename: Albert H M
authors.initials: AH
authors.lastname: van Straten
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D054537:Atrioventricular Block / Q000209:etiology* / Q000628:therapy; D001705:Bioprosthesis / Q000009:adverse effects*; D002037:Bundle-Branch Block / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D011474:Prosthesis Design; D012307:Risk Factors