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Revista Brasileira de Cardiologia Invasiva
On-line version ISSN 2179-8397
LEMOS, Pedro A. et al. Transcatheter aortic valve implantation without permanent pacemaker in a series of consecutive cases: is it possible to predict the risk of atrioventricular block?. Rev. Bras. Cardiol. Invasiva [online]. 2010, vol.18, n.2, pp.135-139. ISSN 2179-8397. http://dx.doi.org/10.1590/S2179-83972010000200006.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly reported as a valid alternative therapeutic option for patients with aortic valve stenosis with high surgical risk. Although effective and relatively safe, TAVI is currently associated to the need of permanent pacemaker in 20% to 30% of the cases, with a number of predictors of this complication already described in the literature METHOD: We report a series of 8 consecutive patients with aortic stenosis treated with TAVI (Corevalve Revalving, Medtronic Inc., USA) RESULTS: The study population had a high surgical risk (on average, STS Score = 22.9% and EuroSCORE = 27.2%). All cases presented at least one high-risk predictor for post-procedure high grade atrioventricular block. The interventional procedure was successfully accomplished in all but one patient who presented a cardiac tamponade and in-hospital death. The transaortic pressure gradient was reduced from 91.3 ± 26.9 mmHg to 19.4 ± 6.3 mmHg. After hospital discharge, the follow-up time ranged from 4 weeks to 12 months. During follow-up, there were no deaths and none of the patients had a new 2nd or 3rd degree atrioventricular block and permanent pacemaker was not required in any of the cases CONCLUSION: Although the lack of a permanent pacemaker in the study population may have occurred by chance, our initial experience suggests that the need of pacemaker following TAVI is not readily predictable with the currently described high-risk predictors.
Keywords : Aortic valve stenosis; Catheterization; Heart valve prosthesis; Heart block; Pacemaker, artificial.