Atrioventricular conduction abnormalities in patients undergoing isolated aortic or mitral valve replacement

Abstract

Cardiac conduction defects are common in patients with aortic valve disease. Several studies have suggested that the spontaneous occurrence of complete heart block in these patients is related to the extent of calcium deposits in the aortic valve and adjacent structures. No studies have been done to relate the occurrence of complete heart block at the time of valve replacement to predictive factors. We evaluated 102 consecutive patients undergoing isolated aortic valve replacement and 100 patients undergoing isolated mitral valve replacement. Although transient complete heart block was relatively common in each group (17.6% and 13%, respectively), we were not able to identify any factors predictive of its occurrence. There was a very low incidence of late heart block in a follow-up period of over four years. Thus, the capability for temporary pacing is mandatory in patients undergoing valve replacement. However, transient complete AV block during the perioperative period does not predict late recurrence of AV block and, therefore, prophylactic pacemaker or electrode implantation during or following transient block appears unnecessary.