Clin Surg | Volume 4, Issue 1 | Clinical Video | Open Access

Surgical Procedure of Adenomyomectomy by Using the Modified Double-Flap Method for the Treatment of Severe Diffuse Adenomyosis

Beata Średniawa1,3,4*, Katarzyna Mitręga3, Piotr Chodór1,3, Oskar Kowalski3,5, Joanna Zembala-John3-5, Janina Stepińska6, Maciej Lesiak8, Waldemar Banasiak7, Marek Grygier8, Zbigniew Kalarus1,3,4 and Marian Zembala2,3

1Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Poland
2Department of Cardio Surgery and Transplantology, Medical University of Silesia, Zabrze, Poland
3Silesian Center for Heart Diseases, Zabrze, Poland
4Kardio-Med Silesia Medical Technology Park, Zabrze, Poland
5School of Public Health in Bytom, Medical University of Silesia, Poland
6Department of Intensive Care, Institute of Cardiology in Warsaw, Poland
7Department of Cardiology, Military Hospital in Wrocław, Poland
8Department of Cardiology, University of Medical Sciences, Poznań, Poland

*Correspondance to: Xinmei Zhang 

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Abstract

Very few data exist on the clinical impact of Transcatheter Aortic Valve Implantation (TAVI) on heart rhythm conduction disturbances and early predictors for Pacemaker (PM), Implantable Cardioverter Defibrillator (ICD) or Cardioverter Defibrillator resynchronization (CRT-D). The aim of this study was to investigate whether the patients after TAVI (in POLTAVI registry) have heart rhythm conductions disturbances and what are the predictors for pacemaker implantation during in-hospital stay. We analyzed 330 patients from POLTAVI registry with severe symptomatic aortic stenosis and high risk for surgery. RBBB (n=11 [18.6%] vs. n=7 [58.3%]; P=0.004) and larger aortic annulus diameter (P=0.007) were significantly more frequent in patients who required PM or ICD or CRT-D implantation after TAVI. Continuous RV pacing during procedure was significantly more frequent in patients who needed PM implantation after TAVI (P=0.0001). Patients who needed pacing device implantation after TAVI had significantly wider QRS (>120 ms) and markedly more often bifascicular block with or without atrio-ventricular I° block (P=0.002). Pacemaker implantation after TAVI was necessary in 19.2% of patients with CoreValve and 8.3% with Edwards Sapien valve. The independent risk factor for pacing after TAVI in logistic regression analysis was CoreValve implantation (HR 3.93 95% CI 1.78 - 8.65; P=0.0007). The independent risk factor for PM implantation is usage of CoreValve. RBBB before the TAVI procedure bifascicular block with or without atrio-ventricular I° block after TAVI, continuous pacing during the TAVI p

Keywords:

Transcathether aortic valve implantation; Atrio-ventricular block; Pacemaker

Citation:

Zhang X. Surgical Procedure of Adenomyomectomy by Using the Modified Double-Flap Method for the Treatment of Severe Diffuse Adenomyosis. Clin Surg. 2019; 4: 2303.

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