TITLE:
A Case of Transient Advanced Atrioventricular Block after Aortic Valve Replacement, Report of a Case
AUTHORS:
Wataru Hashimoto, Shinichiro Taniguchi, Ryuichiro Shibata, Takashi Miura, Tomohiro Odate, Kazuki Hisatomi, Kiyoyuki Eishi
KEYWORDS:
Aortic Valve Replacement; Permanent Pacemaker Implantation; Transient High-Degree Atrioventricular Block; Transcatheter Aortic Valve Implantation
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.3 No.4,
December
13,
2013
ABSTRACT: Approximately 3%-11.8% of cases require permanent pacemaker implantation due to atrioventricular block (AVB) after aortic valve replacement (AVR), and determination of conduction disturbances such as left or right bundle branch block by preoperative electrocardiography is correlated with high risk postoperative permanent pacemaker implantation. Intraoperative risk factors include severe calcification of the aortic valve, prolonged cardiopulmonary bypass time, aortic clamp time. Recently, there have been reports of high rates of pacemaker implantation (14.2%) after transcatheter aortic valve implantation. The time of permanent pacemaker implantation after AVB is often 4-10 days, and the European Society of Cardiology guidelines recommend a period of seven days of persistent atrioventricular block postsurgery prior to permanent pacemaker implantation. We report a 79-year-old woman in which the patient developed high-degree AVB after AVR was performed for severe aortic stenosis with complete right bundle branch block. However, her pulse returned to sinus rhythm 7 days postsurgery.