Risk Factors and Outcomes of Permanent Pacemaker Implantation Following Aortic and Mitral Valve Replacements

Abstract

This study aimed to search risk factors for permanent pacemaker implantation (PPI) following mitral valve and aortic valve replacements with/without tricuspid annuloplasty (TAP). This study retrospectively analysed patients undergoing aortic valve and mitral valve replacements with/without concomitant TAP from January 2014 to December 2017. A total 179 consecutive patients were included into the study, 165 (92.17%) patients comprised no-PPI group and 14 (7.82%) comprised PPI group. A total 179 consecutive patients were 48.0% men; with the mean age 51.7±13.7 years. The two groups did not differ with respect to age, gender, body mass index (BMI), diabetes mellitus (DM), hypertension (HT), ejection fraction % (EF %) and the duration of cardiopulmonary bypass (CPB) (p>0.05). The PPI group had smaller sizes of mechanical or biological aortic valves (p˂0.05), with a significantly higher rate of baseline atrial fibrillation (AF) (p˂0.05). The late mortality rates were 10.9%, 35.7% in the no-PPI and the PPI groups, respectively (p<0.05). The PPI group had significantly higher > 2+ postoperative TR (p<0.05). The sizes of mechanical or biological aortic valves were significantly smaller in the PPI group, which may be due to the narrower and calcific aortic roots. The percentage of patients with a baseline AF was greater in the PPI group. The significantly higher incidence of >2+ postoperative TR among patients receiving PPIs can be deemed merely a result, but not a risk factor.