Permanent Pacemaker Implantation After Sutureless Aortic Valve Replacement With the Perceval Valve:…

Abstract

Objectives: Permanent pacemaker implantation (PPI) remains a concern after sutureless aortic valve replacement (S-AVR) with the Perceval valve. This study aimed to identify preoperative predictors of PPI and evaluate its impact on mid-term survival in a large single-centre cohort.

Methods: We retrospectively analysed 334 patients who underwent S-AVR using the Perceval valve between January 2017 and December 2023. Patients were stratified according to the occurrence of postoperative PPI. Independent predictors of PPI were identified using multivariable logistic regression. Overall survival was assessed using Kaplan–Meier analysis and Cox proportional hazards modelling.

Results: PPI occurred in 21 patients (6.2%). Preoperative right bundle branch block (RBBB) was significantly more prevalent among patients requiring PPI (66.7% vs 11.2%, P < .001). In multivariable logistic regression analysis, preoperative RBBB (Odds ratio [OR] 44.42; P < .001), hypertension, and QRS duration (per 10-milliseconds increase) were independently associated with PPI. The association between RBBB and PPI remained significant in Firth penalized logistic regression analysis (OR, 32.77; P < .001).

Conclusions: Preoperative RBBB is independently associated with PPI after Perceval S-AVR and demonstrated the strongest observed association among the evaluated variables. Careful preoperative risk stratification and postoperative rhythm surveillance may help identify patients at increased risk for conduction-related complications.

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BibTeX RIS

BibTeX

@article{shin2026permanent,
  title = {{Permanent Pacemaker Implantation After Sutureless Aortic Valve Replacement With the Perceval Valve: Predictors and Clinical Implications}},
  author = {Jung-Hoon Shin and Iksung Cho and Chi-Young Shim and Sak Lee and Geu-Ru Hong and Seung-Hyun Lee},
  journal = {Interdisciplinary Cardiovascular and Thoracic Surgery},
  year = {2026},
  month = sep,
  doi = {10.1093/icvts/ivag232},
  url = {https://doi.org/10.1093/icvts/ivag232},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - Permanent Pacemaker Implantation After Sutureless Aortic Valve Replacement With the Perceval Valve: Predictors and Clinical Implications
AU  - Jung-Hoon Shin
AU  - Iksung Cho
AU  - Chi-Young Shim
AU  - Sak Lee
AU  - Geu-Ru Hong
AU  - Seung-Hyun Lee
PY  - 2026
DA  - 2026/09/22
JO  - Interdisciplinary Cardiovascular and Thoracic Surgery
DO  - 10.1093/icvts/ivag232
UR  - https://doi.org/10.1093/icvts/ivag232
AB  - Objectives: Permanent pacemaker implantation (PPI) remains a concern after sutureless aortic valve replacement (S-AVR) with the Perceval valve. This study aimed to identify preoperative predictors of PPI and evaluate its impact on mid-term survival in a large single-centre cohort.  Methods: We retrospectively analysed 334 patients who underwent S-AVR using the Perceval valve between January 2017 and December 2023. Patients were stratified according to the occurrence of postoperative PPI. Independent predictors of PPI were identified using multivariable logistic regression. Overall survival was assessed using Kaplan–Meier analysis and Cox proportional hazards modelling.  Results: PPI occurred in 21 patients (6.2%). Preoperative right bundle branch block (RBBB) was significantly more prevalent among patients requiring PPI (66.7% vs 11.2%, P < .001). In multivariable logistic regression analysis, preoperative RBBB (Odds ratio [OR] 44.42; P < .001), hypertension, and QRS duration (per 10-milliseconds increase) were independently associated with PPI. The association between RBBB and PPI remained significant in Firth penalized logistic regression analysis (OR, 32.77; P < .001).  Conclusions: Preoperative RBBB is independently associated with PPI after Perceval S-AVR and demonstrated the strongest observed association among the evaluated variables. Careful preoperative risk stratification and postoperative rhythm surveillance may help identify patients at increased risk for conduction-related complications.
SN  - 2753-670X
ER  -

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