Back to Search
Start Over
Permanent pacemaker implantation after On-X surgical aortic valve replacement: SWEDEHEART observational study
- Source :
- BMJ Open, Vol 11, Iss 11 (2021), BMJ Open
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- ObjectiveBioprosthetic aortic valves with an extended subannular component, such as transcatheter valves, exert increased compression on the cardiac conduction system and increase the risk for permanent pacemaker implantation. It is unknown if the On-X mechanical prosthetic valve, which has an elongated subannular valve housing, increases the risk of permanent pacemaker implantation following aortic valve replacement.DesignObservational nationwide cohort study.SettingSwedish population-based study.ParticipantsAll patients aged 18–65 years who underwent primary mechanical aortic valve replacement in Sweden between 2005 and 2018. We used the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies register and other Swedish national health-data registers.ExposurePatients implanted with an On-X valve versus patients implanted with other bileaflet mechanical valves.Primary and secondary outcome measuresPrimary outcome measure was permanent pacemaker implantation within 30 days of surgery.ResultsA total of 2602 patients were included, and 581 patients received an On-X valve and 2021 patients received a St Jude Masters/Regent (n=945) or Carbomedics Reduced valve (n=1076). In the total study population, 115 (4.4%) permanent pacemaker implantations were performed within 30 days after aortic valve replacement. In the propensity score matched population, there was no significant difference in the rate of permanent pacemaker implantation in the On-X group compared with the control group: 3.6% (95% CI: 2.4% to 5.5%) vs 4.0% (95% CI: 2.7% to 5.9%), p=0.877.ConclusionsThe On-X prosthetic heart valve was associated with a similarly low risk for permanent pacemaker implantation after aortic valve replacement compared with other conventional bileaflet mechanical valves. The On-X elongated subannular valve housing does not interfere with the cardiac conduction system.
- Subjects :
- medicine.medical_specialty
Pacemaker, Artificial
Heart disease
Population
Cohort Studies
Transcatheter Aortic Valve Replacement
Aortic valve replacement
Risk Factors
Medicine
Humans
education
pacing & electrophysiology
Retrospective Studies
education.field_of_study
business.industry
valvular heart disease
Mechanical Aortic Valve
General Medicine
Aortic Valve Stenosis
medicine.disease
Surgery
Cardiac surgery
Treatment Outcome
Aortic Valve
Electrical conduction system of the heart
business
cardiac surgery
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 20446055
- Volume :
- 11
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....8b649e6f63270c53c60d0d838e10cf09