Predictors of cardiac conduction disorders in patients after aortic valve replacement

M.M. Zaretskyi, B.M. Todurov, O.M. Grytsay, V.B. Demyanchuk, O.V. Zelenchuk
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Abstract

Aortic valve replacement (AVR) is the only effective method of treating aortic stenosis. However, the increasing age of operated patients also increases the surgical risks. The most common complications after aortic valve surgery are similar to those of other cardiac surgeries which include: stroke, deep sternal wound infection, re-operation due to bleeding, myocardial infarction (1–5 %). Cardiac arrhythmias that appear after AVR surgery and require permanent pacemaker (PPM) implantation arise in connection with the anatomical features of the aortic valve, its pathological changes, and traumatic intervention during valve defect correction. A large number of single-center, and a few multi-center studies have been conducted to identify risk factors that could serve as predictors of need in PPM implantation after AVR. Further research in this direction is relevant. Currently there are no clear criteria allowing to identify patients with need for preventive PPM implantation before the AVR surgery due to the high probability of cardiac conduction disorders in the postoperative period. This might reduce the number of complications and reduce the length of a patient’s stay in a hospital.
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主动脉瓣置换术后心脏传导障碍的预测因素
主动脉瓣置换术(AVR)是治疗主动脉瓣狭窄的唯一有效方法。然而,手术患者年龄的增加也增加了手术风险。主动脉瓣手术后最常见的并发症与其他心脏手术相似,包括中风、深胸骨伤口感染、因出血再手术、心肌梗死(1 - 5%)。AVR手术后出现的心律失常,需要植入永久起搏器(PPM),与主动脉瓣的解剖特征、病理改变以及瓣膜缺损矫正过程中的创伤性干预有关。已经进行了大量的单中心和少数多中心研究,以确定可能作为AVR后PPM植入需求预测因素的危险因素。这方面的进一步研究是有意义的。由于术后发生心脏传导障碍的可能性较大,目前尚无明确的标准来确定AVR术前是否需要预防性PPM植入。这可能会减少并发症的数量,缩短病人在医院的住院时间。
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