Shi Mengnan, Zhang Hang, An Jinghui, Shi Fengwu, Yin Hongning, Liu Suyun
Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 of Heping West Road, Xinhua District, Shijiazhuang, 050000, China.
Department of Cardiac Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, China.
J Cardiothorac Surg. 2025 Aug 9;20(1):332. doi: 10.1186/s13019-025-03580-x.
To assess the impact of using the left ventricular lead pacing technique in transcatheter aortic valve replacement (TAVR) procedure.
Thirty patients who underwent TAVR using the left ventricular lead pacing technique between January 2022 and July 2022 were selected as the study group. The research monitored intraoperative pacing effectiveness, the successful placement of "valve-in-valve" during the surgical procedure, the frequency of severe complications both during and after the surgery, surgical duration, total radiation dose, and overall hospitalization expenses. Additionally, the occurrence of adverse events such as mortality, stroke, and myocardial infarction within the three-month period subsequent to the surgery was documented.
All patients underwent successful pacing and completed TAVR with left ventricular lead pacing, with 29 cases conducted through the transfemoral approach and 1 case through the transcarotid approach. A total of 32 interventional valves were effectively implanted, including 2 cases of "valve-in-valve" treatment. Intraoperative circulatory collapse occurred in 2 cases but was promptly managed and resolved. Mild paravalvular leak was observed in 25 cases post-surgery, while no significant paravalvular leaks were detected in the remaining cases. None of the patients experienced III-degree atrioventricular block or other cardiac conduction blocks necessitating temporary or permanent pacemaker implantation post-surgery. Preoperative symptoms were alleviated or completely resolved to varying extents. The average surgery duration was 86.8 ± 18.2 min, total radiation dose was 756.5 ± 131 mGy, and total hospitalization costs were 33.18 ± 2.5 ten thousand yuan (5.10 ± 0.38 ten thousand US dollars). During the three-month postoperative follow-up, no adverse events such as fatality, stroke, or myocardial infarction were reported.
The use of the left ventricular lead pacing technique in TAVR demonstrates both safety and reliability.
评估经导管主动脉瓣置换术（TAVR）中使用左心室导线起搏技术的影响。
选取2022年1月至2022年7月期间采用左心室导线起搏技术进行TAVR的30例患者作为研究组。研究监测术中起搏效果、手术过程中“瓣中瓣”的成功置入情况、手术期间及术后严重并发症的发生频率、手术时长、总辐射剂量以及总体住院费用。此外，记录术后三个月内死亡、中风和心肌梗死等不良事件的发生情况。
所有患者起搏均成功，并通过左心室导线起搏完成了TAVR，其中29例经股动脉途径进行，1例经颈动脉途径进行。共有效植入32个介入瓣膜，包括2例“瓣中瓣”治疗。术中2例发生循环衰竭，但均得到及时处理并解决。术后25例观察到轻度瓣周漏，其余病例未检测到明显瓣周漏。术后无一例患者发生三度房室传导阻滞或其他需要临时或永久起搏器植入的心脏传导阻滞。术前症状均有不同程度缓解或完全消失。平均手术时长为86.8±18.2分钟，总辐射剂量为756.5±131 mGy，总住院费用为33.18±2.5万元（5.10±0.38万美元）。术后三个月随访期间，未报告死亡、中风或心肌梗死等不良事件。
TAVR中使用左心室导线起搏技术具有安全性和可靠性。
