Late conduction defects following aortic valve replacement

J Heart Valve Dis. 2000 Sep;9(5):629-32.


Background and aim of the study: The study aim was to determine the incidence and clinical significance of late cardiac conduction defects (CD) after aortic valve replacement (AVR).

Methods: An analysis was made of 100 consecutive cases after AVR in a prospective outpatient evaluation program.

Results: The perioperative (30-day) mortality rate was 5%, and incidence of perioperative pacemaker implantation 3%. Among patients, 19% had CDs before surgery; a normal ECG was present during all periods in 45% of patients. The most frequent perioperative CD was left anterior hemiblock (LAHB; n = 8), and the most frequent late CD was left bundle branch block (LBBB; n = 8). Overall, 13.7% of operative survivors with normal preoperative and perioperative ECGs developed late CDs; one patient (1%) required pacemaker implantation 82 months after AVR. A further three patients (3%) had worsening of pre-existent CDs. Late CDs occurred over a wide time range (3 to 102 months) after surgery.

Conclusion: There is an important incidence of CDs that occur late after AVR, even if the perioperative ECGs are normal; however, a need for late pacemaker implantation is rare. As CDs may occur at any time after surgery, regular follow up with precise evaluation of ECGs is called for.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery*
  • Female
  • Heart Block / etiology*
  • Heart Valve Prosthesis Implantation* / mortality
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies