XUE Wuchao , LIU Yang , JIN Ping , ZHAI Meng’en , LU Linhe , ZHU Yan , YANG Jian
  • Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi’an, 710032, P. R. China;
YANG Jian, Email: yangjian1212@hotmail.com
Transcatheter aortic valve replacement; balloon post-dilatation; cardiac conduction block; permanent pacemaker implantation; left ventricular ejection fraction
10.7507/1007-4848.202405025
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Objective To analyze the impact of balloon post-dilation on cardiac conduction in patients undergoing transcatheter aortic valve replacement (TAVR). Methods From June 2021 to December 2022, patients with severe aortic valve stenosis or regurgitation who underwent TAVR surgery using domestically produced valves at Xijing Hospital, Air Force Military Medical University were selected. The occurrence of intraoperative and postoperative cardiac conduction block was recorded. According to whether balloon post-dilation was performed during the surgery, patients were divided into the post-dilation group and the non-post-dilation group. The baseline data, postoperative cardiac conduction block occurrence, and cardiac function of the two groups were analyzed. Results A total of 126 patients were included, including 83 males and 43 females, with an average age of 66.6±7.6 years. There were 30 patients in the post-dilation group and 96 patients in the non-post-dilation group. On the first day after TAVR, the average QRS intervals in the post-dilation group and the non-post-dilation group were 105.6±13.8 ms and 125.9±28.2 ms, respectively (P=0.017). At discharge, the average PR intervals in the two groups were 168.7±36.8 ms and 192.1±44.2 ms, respectively (P=0.024). After TAVR, 9 (7.1%) patients developed new atrioventricular block, 5 (4.0%) patients developed complete right bundle branch block, and 33 (26.2%) patients developed complete left bundle branch block. During hospitalization, 2 (1.6%) patients received permanent cardiac pacemakers, both of whom were in the non-post-dilation group. There was no statistical difference in postoperative left ventricular structure and function between the two groups (P>0.05). Conclusion Postoperative expansion using domestically produced interventional valves for TAVR do not increase the incidence of early atrioventricular block and permanent cardiac pacemaker implantation after valve implantation, and there are no significant changes in cardiac structure and function in patients with conduction block in the short term after surgery.