Cross-clamp time >60 min (OR 4.1; 95% CI 1.3-12.9) and concomitant mitral valve surgery (OR 3.8; 95% CI 1.2-12.2) independently predicted permanent pacemaker placement after tricuspid valve surgery.
Observational (n=237)
Yes
What are the perioperative predictors of permanent pacemaker placement and long-term dependence following tricuspid valve surgery?
Cross-clamp time >60 minutes and concomitant mitral valve surgery are independent predictors of the need for permanent pacemaker implantation after tricuspid valve surgery.
Odds Ratio: 4.1 (95% CI 1.3–12.9)
p-value: p=0.015
AIMS: Permanent pacemaker placement (PPM) is often required after valvular surgery and is especially common following tricuspid valve surgery tricuspid valve repair or replacement (TVR). Literature suggests that surgical intervention for isolated tricuspid valve disease is becoming more prevalent. Predictors of PPM dependency following TVR are currently unknown and would be clinically useful from a prognostication standpoint. METHODS AND RESULTS: We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM placement and long-term PPM dependency from 2008 to 2014. Regression analysis was used to determine independent predictors of PPM implantation. A total of 237 patients (age 66 ± 15 years, 29% male) were studied, and the incidence of PPM placement following TVR was 27% (65/237). No significant differences were observed between those who received PPM and those who did not in age (P = 0.092), gender (P = 0.359), and co-morbidities. Regression analysis identified cross-clamp time >60 min (OR 4.1, 95% CI 1.3-12.9, P = 0.015) and concomitant mitral valve surgery (OR 3.8, 95% CI 1.2-12.2, P = 0.026) as independent risk factors for PPM following TVR. Long-term PPM dependency data were only available in 28 patients who received PPM with 14 of these patients developing long-term dependence. The only statistically significant difference noted was an increased frequency of coronary artery disease in the long-term dependent group vs. the non-dependent group (64% vs. 14%, P = 0.018). CONCLUSION: Cross-clamp time >60 min and concomitant mitral valve surgery were independent predictors of PPM implantation following TVR. Long-term PPM dependency is more prevalent after TVR than other types of valvular surgery.
Mar et al. (Mon,) conducted a observational in Tricuspid valve disease requiring surgery (n=237). Cross-clamp time >60 min vs. Cross-clamp time ≤60 min was evaluated on Permanent pacemaker placement (PPM) (OR 4.1, 95% CI 1.3-12.9, p=0.015). Cross-clamp time >60 min (OR 4.1; 95% CI 1.3-12.9) and concomitant mitral valve surgery (OR 3.8; 95% CI 1.2-12.2) independently predicted permanent pacemaker placement after tricuspid valve surgery.