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Title:

Reduction of pacemaker implantation rates after CoreValve® implantation by moderate predilatation.

Document type:
Journal Article; Article
Author(s):
Lange, Philipp; Greif, Martin; Vogel, Armin; Thaumann, Antonia; Helbig, Susanne; Schwarz, Florian; Schmitz, Christoph; Becker, Christoph; D'Anastasi, Melvin; Boekstegers, Peter; Pohl, Tilmann; Laubender, Ruediger P; Steinbeck, Gerhard; Kupatt, Christian
Abstract:
We investigated the impact of the diameter of the valvuloplasty balloon (VB) used for predilation before transcatheter aortic valve implantation (TAVI) on atrioventricular block formation with consecutive need for permanent pacemaker (PP) implantation.TAVI was performed in 269 consecutive patients using the CoreValve prosthesis (Medtronic) via transfemoral access under local anaesthesia with mild analgesic medication. After exclusion of 32 patients with previously implanted PP, 237 patients were included in a retrospective analysis of the impact of VB size on subsequent PP incidence. Implantation success rate was 99.3%. Periprocedural mortality was 0%, and 30-day mortality was 5.9%. PP implantation after TAVI was required by 21.1%. Of 114 patients treated by 25 mm balloon valvuloplasty, a PP was implanted in 27.1%. In 123 patients, who were treated by VB with a <=23 mm diameter, the PP implantation rate decreased to 15.4% (p=0.04). In univariate analysis, larger VB size resulted in a greater prevalence of PP implantation after TAVI. After adjustment by multivariate analysis for baseline clinical and operative characteristics, VB size remained an independent predictor of PP implantation.Moderate balloon predilation in patients undergoing TAVI with the Medtronic CoreValve prosthesis reduces the PP rate without affecting procedural success.
Journal title abbreviation:
EuroIntervention
Year:
2014
Journal volume:
9
Journal issue:
10
Pages contribution:
1151-7
Language:
eng
Fulltext / DOI:
doi:10.4244/EIJV9I10A195
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/24561731
Print-ISSN:
1774-024X
TUM Institution:
I. Medizinische Klinik und Poliklinik (Kardiologie)
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