Recovery From Conduction Abnormalities After Aortic Valve Replacement Using Edwards Intuity.

Abstract

This study investigated the incidences of various conduction abnormalities after rapid-deployment aortic valve replacement using Edwards Intuity (Edwards Lifesciences, Irvine, CA) valve and the temporal changes of these abnormalities during the postoperative course. We modified the procedure by placing additional anchoring sutures and using a 5-mm videoscope to achieve "complete annulus fitting." Direct visual inspection by videoscopy inside and outside the valve guaranteed complete annulus fitting. Overall 167 patients who underwent rapid-deployment aortic valve replacement during the study period were included in the analysis of postoperative conduction abnormalities. After rapid-deployment aortic valve replacement, third-degree atrioventricular block occurred in 18 patients (10.8%), but 15 patients recovered to sinus rhythm at median postoperative 10 days. Left or right bundle branch block occurred in 67 patients (40.1%), but 44 patients returned to their original rhythm at median postoperative 12 days. Delayed-onset conduction abnormalities occurred in 35 patients (21.0%) at median postoperative day 4, and spontaneously regressed in 28 patients. The incidence of conduction abnormalities after rapid-deployment aortic valve replacement was high, but most of these abnormalities spontaneously recovered. These good results may be attributed to our implantation technique.