Left ventricular wire pacing technique in transcatheter aortic valve replacement

Abstract

Objective To assess the impact of using the left ventricular lead pacing technique in transcatheter aortic valve replacement (TAVR) procedure.
Methods Thirty patients who underwent TAVR using the left ventricular lead pacing technique between January 2022 and July 2022 were selected as the study group. The research monitored intraoperative pacing effectiveness, the successful placement of “valve-in-valve” during the surgical procedure, the frequency of severe complications both during and after the surgery, surgical duration, total radiation dose, and overall hospitalization expenses. Additionally, the occurrence of adverse events such as mortality, stroke, and myocardial infarction within the three-month period subsequent to the surgery was documented.
Results All patients underwent successful pacing and completed TAVR with left ventricular lead pacing, with 29 cases conducted through the transfemoral approach and 1 case through the transcarotid approach. A total of 32 interventional valves were effectively implanted, including 2 cases of “valve-in-valve” treatment. Intraoperative circulatory collapse occurred in 2 cases but was promptly managed and resolved. Mild paravalvular leak was observed in 25 cases post-surgery, while no significant paravalvular leaks were detected in the remaining cases. None of the patients experienced III-degree atrioventricular block or other cardiac conduction blocks necessitating temporary or permanent pacemaker implantation post-surgery. Preoperative symptoms were alleviated or completely resolved to varying extents. The average surgery duration was 86.8 ± 18.2 min, total radiation dose was 756.5 ± 131 mGy, and total hospitalization costs were 33.18 ± 2.5 ten thousand yuan (5.10 ± 0.38 ten thousand US dollars). During the three-month postoperative follow-up, no adverse events such as fatality, stroke, or myocardial infarction were reported.
Conclusion The use of the left ventricular lead pacing technique in TAVR demonstrates both safety and reliability.

Keywords: Transcatheter Aortic Valve Replacement Aortic Valve Stenosis; Heart Valve Prosthesis Implantation; Cardiac Pacing; Artificial.