Conduction Disorders And Their Clinical Impact After Sutureless/Rapid Deployment Aortic Bioprosthesis


  • Ricardo Ferreira Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Marta Figueiral Health sciences school, Universidade Beira Interior, Covilhã, Portugal
  • André Sena Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Filipe Pereira Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Nádia Junqueira Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Tiago Velho Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Ana Almeida Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Angelo Nobre Cardiothoracic Surgery Department, Santa Maria Hospital, Lisbon, Portugal
  • Fausto Pinto Cardiology Department, Santa Maria Hospital, Lisbon, Portugal



Aortic valve replacement, rapid deployment bioprostheses, pacemaker, complete atrioventricular block


Introduction: Aortic stenosis remains the number one heart valve pathology. The drive to improve the surgical outcomes brought to focus rapid deployment valves (RDV), which reduce aortic cross-clamping and cardio-pulmonary bypass (CPB) times. However, some centers have reported a higher rate of conduction abnormalities and permanent pacemaker (PPM) implantation.

The aim of this study was to investigate the incidence of conduction abnormalities after aortic valve replacement with RDV, as well as its impact on immediate postoperative outcomes.

Methods: Retrospective analysis of associated conductions disorders and PPM implantation rates, as well as post-operative outcomes of all patients undergoing isolated aortic valve replacement between April 2014 and December 2019 with an RDV. Comparative analysis between the group with PPM implantation and the one with no PPM implantation. Patients with previous PPM implantation, reoperations and patients with missing pre or postoperative ECG data were excluded.

Results: We studied 201 patients. The majority of conduction abnormalities were left bundle branch block (54,0%). Twenty-six PPM were implanted (12,6%).

Pre-operative characteristic between the groups were similar and little differences were found in regard to most complications. However, the PPM group showed significantly higher rates of stroke (7.7% vs 0.0%, p=0.016) and hemodynamic support for longer than 24 hours (60.0% vs 36.1%, p=0.028). From the multivariable analysis, preoperative right bundle branch block was the only independent risk factor associated with PPM.

Conclusions: PPM implantation rates with RDV are relatively high and are associated with prolonged hospital and ICU stays, postoperative stroke rates and requirement of aminergic support. Their use should be made on a case-by-case basis taking into consideration the existence of preoperative conduction disorders, especially right bundle branch block.


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How to Cite

Ferreira R, Figueiral M, Sena A, Pereira F, Junqueira N, Velho T, Almeida A, Nobre A, Pinto F. Conduction Disorders And Their Clinical Impact After Sutureless/Rapid Deployment Aortic Bioprosthesis. Rev Port Cir Cardiotorac Vasc [Internet]. 2023 Apr. 4 [cited 2023 May 30];30(1):23-30. Available from:



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