Key result
Dual chamber (DDD) pacing resulted in immediate marked hemodynamic improvement and resolution of systolic anterior motion of the mitral valve in a patient with low cardiac output syndrome post-AVR.
Why the study?
Does pacing improve cardiac output in patients with low cardiac output syndrome following elective aortic valve replacement?
Case Report (n=1)
No
Does pacing improve cardiac output in patients with low cardiac output syndrome following elective aortic valve replacement?
Invasive pacemaker systems can significantly augment cardiac output in patients with dynamic LV outflow tract obstruction following aortic valve replacement.
May support DDD pacing trial in select post-AVR low-output cases with SAM; hypothesis-generating and requires prospective validation.
We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV) outflow obstruction after aortic valve replacement (AVR). This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT) obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.
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Muhammad Ishaq (2012) conducted a case report in Low cardiac output syndrome following aortic valve replacement (n=1). Dual chamber (DDD) pacing was evaluated on Hemodynamic improvement and reduction of LVOT obstruction. Dual chamber (DDD) pacing resulted in immediate marked hemodynamic improvement and resolution of systolic anterior motion of the mitral valve in a patient with low cardiac output syndrome post-AVR.
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