Does Balloon Dilatation Increase the Need for A Permanent Pacemaker in Sutureless Aortic Valve Replacement?

REYHANCAN A., SHEHU F., BÜYÜKADALI M., CHOUSEIN-HÜSEYİN S., GÜÇLÜ O., CANBAZ S.

Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.32, ss.90, 2024 (SCI-Expanded, Scopus)

Özet

Objective: This study aimed to present the results of balloon dilatation in sutureless valves considering the temporary and permanent need for a pacemaker. Methods: Thirty-eight patients (27 females, 11 males; mean age: 69.42±4.85 years; range, 61 to 82 years) who underwent surgical aortic valve replacement with a sutureless aortic valve bioprosthesis between January 2019 and June 2024 and received balloon dilation at 4 atm (standard atmosphere) pressure for 30 sec during the procedure were retrospectively evaluated. Demographic data, preoperative and postoperative echocardiographic data, and postoperative follow-up data of the patients were collected. Results: On preoperative echocardiographic evaluation, the mean aortic root diameter was 20.99±2.24 mm, the ejection fraction was 59.29±9.57%, and the mean preoperative aortic valve gradient was 38.08±7.31 mmHg. Isolated aortic valve replacement was performed in 22 (57.9%) patients, concomitant coronary bypass was performed in 14 (36.8%) patients, and ascending aorta replacement was performed in two (5.3%) patients. A small valve was inserted in six patients, a medium valve in 13 patients, a large valve in 17 patients, and an extra-large valve in two patients. The mean postoperative aortic valve gradient was 11.52±3.36 mmHg. After surgery, three (7.9%) patients were transferred to the intensive care unit with temporary pacemakers. Permanent pacemaker implantation was required in three (7.9%) patients due to complete atrioventricular block. Conclusion: Although the clinical results with sutureless aortic bioprostheses are satisfactory, the use of balloon dilatation increases the need for permanent pacemakers.