[Disorders of intraventricular conduction in patients with calcified aortic valve diseases: pre- and postoperative incidence and effect on prognosis following aortic valve replacement].

The incidence and prognostic significance of intraventricular conduction disturbances following aortic valve replacement was studied in a retrospective analysis of the records of 210 patients who had undergone aortic valve replacement for calcified aortic valve disease (dominant stenosis) between 05/01/1978 and 09/30/1983. Preoperatively, left anterior hemiblock was a common finding (9.6%), whereas LBBB, RBBB, and RBBB + LAFB were only found in 1.9, 1.0, and 1.0%, respectively. Following aortic valve replacement, the incidence of new conduction disturbances was 22.1% (n = 46): 19 LBBB, 16 LAFB, 6 RBBB, 3 RBBB + LAFB, 2 complete AV-blocks. In about half of the cases of LBBB and LAFB the ECG normalized within one week postoperatively. Thus, the incidence of persisting conduction disturbances was only 14.4%. Four patients died early (early mortality rate 1.9%), and 11 patients died later postoperatively during a 38 month follow-up. The 4-year cardiac survival rate of patients with pre- and/or postoperative conduction disturbances was similar to the 4-year cardiac survival rate of those patients who had never shown this complication (93.2 +/- 4.1 vs. 94.7 +/- 2.1%).