Perioperative predictors of permanent pacing and long-term dependence following tricuspid valve surgery: A multicentre analysis

Philip L. Mar, Christopher R. Angus, Rajesh Kabra, Christopher K. Migliore, Rohan Goswami, Leah A. John, Yixi Tu, Rakesh Gopinathannair

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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 We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM and results 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.

Original languageEnglish (US)
Pages (from-to)1988-1993
Number of pages6
JournalEuropace
Volume19
Issue number12
DOIs
StatePublished - Dec 1 2017

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Tricuspid Valve
Mitral Valve
Regression Analysis
Multicenter Studies
Coronary Artery Disease
Retrospective Studies
Morbidity
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Perioperative predictors of permanent pacing and long-term dependence following tricuspid valve surgery : A multicentre analysis. / Mar, Philip L.; Angus, Christopher R.; Kabra, Rajesh; Migliore, Christopher K.; Goswami, Rohan; John, Leah A.; Tu, Yixi; Gopinathannair, Rakesh.

In: Europace, Vol. 19, No. 12, 01.12.2017, p. 1988-1993.

Research output: Contribution to journalArticle

Mar, PL, Angus, CR, Kabra, R, Migliore, CK, Goswami, R, John, LA, Tu, Y & Gopinathannair, R 2017, 'Perioperative predictors of permanent pacing and long-term dependence following tricuspid valve surgery: A multicentre analysis', Europace, vol. 19, no. 12, pp. 1988-1993. https://doi.org/10.1093/europace/euw391
Mar, Philip L. ; Angus, Christopher R. ; Kabra, Rajesh ; Migliore, Christopher K. ; Goswami, Rohan ; John, Leah A. ; Tu, Yixi ; Gopinathannair, Rakesh. / Perioperative predictors of permanent pacing and long-term dependence following tricuspid valve surgery : A multicentre analysis. In: Europace. 2017 ; Vol. 19, No. 12. pp. 1988-1993.
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abstract = "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 We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM and results 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.",
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T2 - A multicentre analysis

AU - Mar, Philip L.

AU - Angus, Christopher R.

AU - Kabra, Rajesh

AU - Migliore, Christopher K.

AU - Goswami, Rohan

AU - John, Leah A.

AU - Tu, Yixi

AU - Gopinathannair, Rakesh

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N2 - 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 We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM and results 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.

AB - 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 We conducted a multicentre, retrospective study to assess perioperative factors of TVR that predispose to PPM and results 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.

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