Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation

Nadine Kawkabani; Omar Boustros; Rita Farah; Roula Darwish; Moussa Abi Ghanem; Hassan Souidan; Hiba Zeidh; Mohammad Hadi El Charif; Bassam Abou Khalil

doi:doi:10.11648/j.ijcts.20200603.12

Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation

Nadine Kawkabani, Omar Boustros, Rita Farah, Roula Darwish, Moussa Abi Ghanem, Hassan Souidan, Hiba Zeidh, Mohammad Hadi El Charif, Bassam Abou Khalil

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 3)

Received: 1 March 2020 Accepted: 3 August 2020 Published: 20 August 2020

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 6, Issue 3)
DOI	10.11648/j.ijcts.20200603.12
Page(s)	44-48
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Aortic Valve Replacement, New Technique, Incidence of Pace Maker Implantation

References

[1]	Klapkowski A, Pawlaczyk R, Kempa M, Jagielak D et al. Complete atrioventricular block after isolated aortic valve replacement. Kardiol pol 2016; 74: 985-993.
[2]	Matthews IG, Fazal IA, Bates M, Turley A. In patients undergoing aortic valve replacement, what factors predict the requirement for permanent pacemaker implantation?
[3]	Hwang YM, Kim J, Lee HL, Kim M et al. Conduction disturbances after isolated surgical aortic valve replacement in degenerative aortic stenosis. The journal of Thoracic and cardiovascular surgery2017; 154: 1556-1566.
[4]	Erdogan HB, Kayalar N, Ardal H, Omeruglu SN et al. Risk factors for requirement of permanent pacemaker implantation after aortic valve replacement. J Card Surg 2006; 21: 211-215.
[5]	Limomgelli G, Ducceschi V, D ‘Andrea A, Renzulli A, Sarrubi B, De Feo M, Cerasuolo F, Calabro R, Cotrufo M: Risk factors for pacemaker implantation following aortic valve replacement: a single centre experience. Heart, 2003; 89: 901-904.
[6]	Bagur R, Manazzoni JM, Dumont E, Doyle D et al: Permanent pacemaker implantation following isolated aortic valve replacement in a large cohort of elderly patients with severe aortic stenosis. Heart 2011; 97: 1687-1694.
[7]	Nardi P, Pellegrino A, Scafuri A, Bellos K et al. Permanent pacemaker implantation after isolated aortic valve replacement: incidence, risk factors and surgical technical aspects. Journal of cardiovascular medicine 2010; 11: 14-19.
[8]	Dawkins S, Hobson A, Kalra P, Tang A et al. Permanent pacemaker implantation after isolated aortic valve replacement: incidence, indications and predictors. Ann thorac Surg 2008; 85: 108-112.
[9]	Glauber M, Lio A, Miceli A. Sutureless technology for aortic valve replacement: Looking beyond crossclamp time. J Thorac Cardiovasc Surg. 2016; 151: 1637-1638.
[10]	Yanagawa B, Cruz J, Boisvert L, Bonneau D. A simple modification to lower incidence of heart block with sutureless valve implantation. Eur Heart J. 2013; 34: 1894-1905.
[11]	Kostopoulo A, Karyofillis P, Livanis E et al. Permanent pacing after transcatheter aortic valve implantation of a corevalve prosthesis as determined by electrocardiographic and electrophysiological predictors: a single-centre experience. Europace, 2016; 18: 131-137. doi: 10.1093/europace/euc137.
[12]	Van der Boon R, Houthuizem P, Urena M et al. Trends I n the occurrence of new conduction abnormalities after transcatheter aortic valve implantation. Catheter Cardiovasc Intervent. 2015; 85: 144-152. doi: 10.1002/cod.25765.
[13]	Onalan O, Crystal A, Lashevsky I, Khalameizer V et al. Determinants of pacemaker dependency after coronary and/or mitral or aortic valve surgery with long term follow-up. Am J Cardiol 2008; 101: 203-208.
[14]	Merin O, Dearini J, Hyberger L Schaff H et al. Indications, effectiveness and long –term pacing dependency after cardiac surgery. Am J Cardiol 1997; 80: 1309-1313.
[15]	Toggweiler S, Kobza R. Pacemaker implantation after transcatheter aortic valve: Why is this still happenning? J Thorac Dis 2018; 10 (Suppl 30): 3614-3619. doi: 10.21037/jtd.2018.06.103.

Cite This Article

Plain Text BibTeX RIS

APA Style

Nadine Kawkabani, Omar Boustros, Rita Farah, Roula Darwish, Moussa Abi Ghanem, et al. (2020). Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. International Journal of Cardiovascular and Thoracic Surgery, 6(3), 44-48. https://doi.org/10.11648/j.ijcts.20200603.12

Copy | Download

ACS Style

Nadine Kawkabani; Omar Boustros; Rita Farah; Roula Darwish; Moussa Abi Ghanem, et al. Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(3), 44-48. doi: 10.11648/j.ijcts.20200603.12

Copy | Download

AMA Style

Nadine Kawkabani, Omar Boustros, Rita Farah, Roula Darwish, Moussa Abi Ghanem, et al. Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. Int J Cardiovasc Thorac Surg. 2020;6(3):44-48. doi: 10.11648/j.ijcts.20200603.12

Copy | Download

@article{10.11648/j.ijcts.20200603.12,
  author = {Nadine Kawkabani and Omar Boustros and Rita Farah and Roula Darwish and Moussa Abi Ghanem and Hassan Souidan and Hiba Zeidh and Mohammad Hadi El Charif and Bassam Abou Khalil},
  title = {Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {6},
  number = {3},
  pages = {44-48},
  doi = {10.11648/j.ijcts.20200603.12},
  url = {https://doi.org/10.11648/j.ijcts.20200603.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200603.12},
  abstract = {In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation
AU  - Nadine Kawkabani
AU  - Omar Boustros
AU  - Rita Farah
AU  - Roula Darwish
AU  - Moussa Abi Ghanem
AU  - Hassan Souidan
AU  - Hiba Zeidh
AU  - Mohammad Hadi El Charif
AU  - Bassam Abou Khalil
Y1  - 2020/08/20
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcts.20200603.12
DO  - 10.11648/j.ijcts.20200603.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 44
EP  - 48
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20200603.12
AB  - In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.
VL  - 6
IS  - 3
ER  -

Copy | Download

Author Information

Nadine Kawkabani

Cardiothoracic Anesthesia Department, Saint George Hospital Medical Center, Balamand University, Saint George University, Beirut, Lebanon
Omar Boustros

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon
Rita Farah

Faculty of Pharmacy, Lebanese University, INSPECT, LB, Beirut, Lebanon
Roula Darwish

Cardiothoracic Anesthesia Department, Saint George Hospital Medical Center, Balamand University, Saint George University, Beirut, Lebanon
Moussa Abi Ghanem

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon
Hassan Souidan

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon
Hiba Zeidh

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon
Mohammad Hadi El Charif

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon
Bassam Abou Khalil

Cardiothoracic Surgery Department, Saint George Hospital, Balamand University, Saint George University, Beirut, Lebanon

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Nadine Kawkabani, Omar Boustros, Rita Farah, Roula Darwish, Moussa Abi Ghanem, et al. (2020). Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. International Journal of Cardiovascular and Thoracic Surgery, 6(3), 44-48. https://doi.org/10.11648/j.ijcts.20200603.12

Copy | Download

ACS Style

Nadine Kawkabani; Omar Boustros; Rita Farah; Roula Darwish; Moussa Abi Ghanem, et al. Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. Int. J. Cardiovasc. Thorac. Surg. 2020, 6(3), 44-48. doi: 10.11648/j.ijcts.20200603.12

Copy | Download

AMA Style

Nadine Kawkabani, Omar Boustros, Rita Farah, Roula Darwish, Moussa Abi Ghanem, et al. Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation. Int J Cardiovasc Thorac Surg. 2020;6(3):44-48. doi: 10.11648/j.ijcts.20200603.12

Copy | Download

@article{10.11648/j.ijcts.20200603.12,
  author = {Nadine Kawkabani and Omar Boustros and Rita Farah and Roula Darwish and Moussa Abi Ghanem and Hassan Souidan and Hiba Zeidh and Mohammad Hadi El Charif and Bassam Abou Khalil},
  title = {Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {6},
  number = {3},
  pages = {44-48},
  doi = {10.11648/j.ijcts.20200603.12},
  url = {https://doi.org/10.11648/j.ijcts.20200603.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20200603.12},
  abstract = {In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Reproducible and Reliable Modified Technique of Surgical Aortic Valve Replacement That Decreases the Incidence of Permanent Pace Maker Implantation
AU  - Nadine Kawkabani
AU  - Omar Boustros
AU  - Rita Farah
AU  - Roula Darwish
AU  - Moussa Abi Ghanem
AU  - Hassan Souidan
AU  - Hiba Zeidh
AU  - Mohammad Hadi El Charif
AU  - Bassam Abou Khalil
Y1  - 2020/08/20
PY  - 2020
N1  - https://doi.org/10.11648/j.ijcts.20200603.12
DO  - 10.11648/j.ijcts.20200603.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 44
EP  - 48
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20200603.12
AB  - In the last few years, a significant increase in the number of patients with aortic stenosis requiring surgical or transcatheter aortic replacement (SAVR) or (TAVR) has been observed due to the larger aging population. Conduction disturbances requiring permanent pace maker implantation (PPMI) has been observed after SAVR and TAVR. In fact the incidence of PPMI following SAVR reached 11 to 13% while it occurred in7 to 36% of patients undergoing TAVR. The majority of rhythm problems are secondary to a significant trauma to the conduction system. In order to decrease the incidence of PPMI in patients undergoing SAVR, we developed a modified technique of SAVR that we applied on a group of 63 patients (group B) and we compared the incidence of PPMI in this group to the one observed in a second group of 62 patients who underwent the classic SAVR (group A). It was significantly lower in group B (3.2% vs 14.5%). In conclusion, The low incidence of PPMI (3.2%) observed in the modified SAVR group encourages us to recommend this technique in all patients undergoing biological SAVR especially that this technique is simple to apply highly reproducible and reliable. However, further multicenter and larger studies will help confirm our findings.
VL  - 6
IS  - 3
ER  -

Copy | Download