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无针线快速植入主动脉瓣假体一年后新发及持续性新左束支传导阻滞的预测因素

Predictors of New and Persistent New Left Bundle Branch Block One Year after the Implantation of a Sutureless and Rapid-Deployment Aortic Valve Prosthesis.

作者信息

Januszek Rafał, Balan Robert

机构信息

Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland.

Department of Cardiac Surgery, Klinikum Passau, 94-032 Passau, Germany.

出版信息

Diseases. 2023 Aug 3;11(3):100. doi: 10.3390/diseases11030100.

DOI:10.3390/diseases11030100
PMID:37606471
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10443328/
Abstract

INTRODUCTION

Conduction disorders following aortic valve replacement therapy (AVR), either surgical or percutaneous, are related to a higher risk of complete atrioventricular block and permanent pacemaker implantation (PPI).

AIM

The objective of this study was to assess risk factors regarding the incidence of new postoperative and persistent new left bundle branch block (LBBB) 1 year after the implantation of a sutureless/rapid-deployment (SURD) aortic valve prosthesis.

MATERIAL AND METHODS

The current study included 200 consecutive patients treated with isolated or concomitant AVR between May 2014 and May 2017 at the Department of Cardiac Surgery in Pasawa with SURD aortic valve EDWARDS INTUITY Elite implantation. The patients were divided according to the presence of new postoperative LBBB (67 patients, 33.5%) and persistent new LBBB 1 year after AVR (35 patients, 17.5%). A comparative analysis was performed between patients with and without new LBBB after AVR and those with and without persistent LBBB 1 year after AVR. Univariate and multivariate regression analyses were conducted to extract the risk factors of LBBB occurrence.

RESULTS

Among the risk factors for the lack of new LBBB development after AVR, Euroscore II ( < 0.001) was found, while for the occurrence of persistent new LBBB 1 year after AVR, atrial fibrillation ( = 0.001), length of hospital stay ( = 0.001) and body mass index ( = 0.004) were noted.

CONCLUSIONS

Patients with new or persistent new LBBB 1 year after AVR had lower mean Euroscore II and BMI values. Their stay at the hospital was also shorter.

摘要

引言

主动脉瓣置换术(AVR),无论是外科手术还是经皮手术,术后传导障碍与完全性房室传导阻滞和永久性起搏器植入(PPI)的较高风险相关。

目的

本研究的目的是评估在植入无缝合/快速部署(SURD)主动脉瓣膜假体后1年,关于新的术后和持续性新左束支传导阻滞(LBBB)发生率的风险因素。

材料与方法

本研究纳入了2014年5月至2017年5月期间在帕萨瓦心脏外科接受单纯或联合AVR治疗的200例连续患者,采用SURD主动脉瓣膜爱德华兹INTUITY Elite进行植入。根据术后是否出现新的LBBB(67例患者,33.5%)以及AVR术后1年是否存在持续性新LBBB(35例患者,17.5%)对患者进行分组。对AVR后有或无新LBBB的患者以及AVR后1年有或无持续性LBBB的患者进行了比较分析。进行单因素和多因素回归分析以提取LBBB发生的风险因素。

结果

在AVR后未出现新LBBB的风险因素中,发现欧洲心脏手术风险评估系统II(Euroscore II)(<0.001),而对于AVR后1年出现持续性新LBBB,发现房颤(=0.001)、住院时间(=0.001)和体重指数(=0.004)。

结论

AVR后1年出现新的或持续性新LBBB的患者平均Euroscore II和BMI值较低。他们的住院时间也较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac5/10443328/318154264ef7/diseases-11-00100-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac5/10443328/318154264ef7/diseases-11-00100-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ac5/10443328/318154264ef7/diseases-11-00100-g001.jpg

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J Cardiol. 2022 Sep;80(3):204-210. doi: 10.1016/j.jjcc.2022.04.011. Epub 2022 May 20.
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Early and late outcomes of surgical aortic valve replacement with sutureless and rapid-deployment valves versus transcatheter aortic valve implantation: Meta-analysis with reconstructed time-to-event data of matched studies.与经导管主动脉瓣植入术相比,使用无缝合和快速部署瓣膜进行外科主动脉瓣置换术的早期和晚期结果:对匹配研究的事件发生时间数据进行重建的荟萃分析。
Catheter Cardiovasc Interv. 2022 May;99(6):1886-1896. doi: 10.1002/ccd.30162. Epub 2022 Mar 21.
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Eur J Cardiothorac Surg. 2022 Sep 2;62(4). doi: 10.1093/ejcts/ezac164.
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Outcomes in Patients with Left Bundle Branch Block after Rapid Deployment Aortic Valve Replacement.
Thorac Cardiovasc Surg. 2023 Oct;71(7):528-534. doi: 10.1055/s-0042-1742361. Epub 2022 Feb 2.
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Increased Rate of New-onset Left Bundle Branch Block in Patients With Bicuspid Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation (From a National Registry).经导管主动脉瓣植入术后二叶式主动脉瓣狭窄患者新发左束支传导阻滞的发生率增加(来自国家注册中心)。
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