Evidence map›Paper›PMID 39440421›Full record

ArticleCirculation2025

Conduction Disturbances and Outcome After Surgical Aortic Valve Replacement in Patients With Bicuspid and Tricuspid Aortic Stenosis.

Johan O Wedin, Viktor Näslund, Sergey Rodin, Oscar E Simonson, Frank A Flachskampf, Stefan K James, Elisabeth Ståhle, Karl-Henrik Grinnemo

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In one paragraph

Article in Circulation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Johan O WedinCardio-Thoracic Translational Medicine Lab (J.O.W., S.R., O.E.S., E.S., K-H.G.), Uppsala University, Sweden.ORCID 0000-0002-3867-8568
Viktor NäslundDepartments of Cardiothoracic Surgery and Anesthesiology (J.O.W., V.N. S.R., O.E.S., E.S., K-H.G.), Uppsala University Hospital, Sweden.ORCID 0009-0009-5115-9509
Sergey RodinCardio-Thoracic Translational Medicine Lab (J.O.W., S.R., O.E.S., E.S., K-H.G.), Uppsala University, Sweden.
Oscar E SimonsonCardio-Thoracic Translational Medicine Lab (J.O.W., S.R., O.E.S., E.S., K-H.G.), Uppsala University, Sweden.
Frank A FlachskampfMedical Sciences (F.A.F., S.K.J.), Uppsala University, Sweden.ORCID 0000-0002-7401-278X
Stefan K JamesMedical Sciences (F.A.F., S.K.J.), Uppsala University, Sweden.ORCID 0000-0003-4413-9736
Elisabeth StåhleCardio-Thoracic Translational Medicine Lab (J.O.W., S.R., O.E.S., E.S., K-H.G.), Uppsala University, Sweden.
Karl-Henrik GrinnemoCardio-Thoracic Translational Medicine Lab (J.O.W., S.R., O.E.S., E.S., K-H.G.), Uppsala University, Sweden.ORCID 0000-0002-6100-6209

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to compare the incidence and prognostic implications of new-onset conduction disturbances after surgical aortic valve replacement (SAVR) in patients with bicuspid aortic valve (BAV) aortic stenosis (AS) versus patients with tricuspid aortic valve (TAV) AS (ie, BAV-AS and TAV-AS, respectively). Additionally, the study included stratification of BAV patients according to subtype.

methodsIn this cohort study, the incidence of postoperative third-degree atrioventricular (AV) block with subsequent permanent pacemaker requirement and new-onset left bundle-branch block (LBBB) was investigated in 1147 consecutive patients without preoperative conduction disorder who underwent isolated SAVR (with or without ascending aortic surgery) between January 1, 2005, and December 31, 2022. The groups were stratified by aortic valve morphology (BAV, n=589; TAV, n=558). The outcomes of interests were new-onset third-degree AV block or new-onset LBBB during the index hospitalization. The impact of new-onset postoperative conduction disturbances on survival was investigated in BAV-AS and TAV-AS patients during a median follow-up of 8.2 years. BAV morphology was further categorized according to the Sievers and Schmidtke classification system (possible in 307 BAV-AS patients) to explore association between BAV subtypes and new-onset conduction disturbances after SAVR.

resultsThe overall incidence of third-degree AV block and new-onset LBBB after SAVR was 4.5% and 7.8%, respectively. BAV-AS patients had a higher incidence of both new-onset third-degree AV block (6.5% versus 2.5%;

conclusionsNew-onset LBBB after SAVR is associated with increased all-cause mortality during follow-up, and is more frequent complication in BAV AS patients compared with TAV-AS patients. BAV-AS patients with fusion of the right- and non-coronary cusps have an increased risk for conduction disturbances after SAVR. This should be taken into consideration when managing these patients.

Indexed as

Aortic ValveAortic Valve StenosisAtrioventricular BlockBicuspid Aortic Valve DiseaseBundle-Branch BlockHeart Valve Prosthesis ImplantationPostoperative ComplicationsAgedAged, 80 and overFemaleHumansIncidenceMaleMiddle AgedPacemaker, ArtificialRetrospective Studiesatrioventricular blockbicuspid aortic valve diseasebundle-branch blockcardiac conduction system diseasepacemaker, artificialprognosis

Identifiers

PMID39440421
PMCPMC11789612

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.