Background and Aim. Conduction disturbances leading to permanent pacemaker implantation (PPMI) remains a common complication for TAVR procedures, particularly when self-expanding valves are used. We compared the 30-day incidence of new-onset left bundle branch block (LBBB) and permanent pacemaker implantation (PPMI) rate between two consecutive groups using either conventional 3-cusp coplanar view (CON) and right/left cusp-overlap view (COVL) for implantation. Methods and Results. We retrospectively compared 257 consecutive patients undergoing TAVR with self-expandable valves using either CON (n = 101) or COVL (n = 156) in four intermediate/low volume centers. There were no significant differences in baseline characteristics between the groups. The 30-day incidence of new-onset LBBB (12.9% vs. 5.8%; ) and PPMI rate (17.8% vs. 6.4%; ) was significantly lower when using the COVL implantation view. There was no difference between the CON and COVL groups in 30-day incidence of death (4.9% vs. 2.6%), any stroke (0% vs. 0.6%), and the need for surgical aortic valve replacement (0% for both groups). Conclusion. Using the COVL view for implantation, we achieved a significant reduction of the LBBB and PPMI rate after TAVR in comparison with the traditional CON view, without compromising the TAVR outcomes when using self-expandable prostheses.

中文翻译：

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具有自动膨胀阀的TAVR的尖锐重叠视图对30天电导扰动的影响

背景和目的。导致永久性起搏器植入（PPMI）的传导干扰仍然是TAVR手术的常见并发症，尤其是在使用自膨胀阀的情况下。我们使用传统的三尖瓣共面视图（CON）和右/左尖瓣重叠视图比较了两个连续组之间新发左束支传导阻滞（LBBB）和永久起搏器植入（PPMI）的30天发生率（ COVL）植入。方法和结果。我们回顾性比较了连续257例接受TAVR并使用CON（n  = 101）或COVL（n = 156）在四个中等/低音量中心。两组之间的基线特征无显着差异。新发LBBB的30天发病率（12.9％vs. 5.8％；）和PPMI率（17.8％对6.4％；使用COVL植入视图时，）显着降低。CON和COVL组之间在30天死亡发生率（4.9％vs. 2.6％），任何中风（0％vs. 0.6％）以及需要手术主动脉瓣置换（两者均为0％）之间没有差异。组）。结论。使用COVL植入视图，与传统的CON相比，我们在TAVR后可以显着降低LBBB和PPMI的发生率，而在使用自扩张假体时不会损害TAVR的结果。