Salim YAŞAR, Özkan ERAVCI, Serdar FIRTINA, Mehmet Sadık KARPAT, Erkan YILDIRIM, Tayfun ÖZDEM, Emre KUBAT, Kubilay KARABACAK, Hasan Kutsi KABUL
Gulhane Medical Journal - 2026;68(2):127-131
Aims: Data on permanent pacemaker implantation (PPI) after the Ozaki procedure are limited. This study evaluates the incidence of PPI and compares echocardiographic and clinical outcomes between patients with PPI and without PPI. Methods: We conducted a retrospective study to evaluate patients who underwent the Ozaki procedure between January 1, 2019, and September 1, 2022. Patients were divided into PPI and non-PPI groups after the procedure. Preoperative and postoperative echocardiographic parameters, surgical details, and clinical outcomes were compared. Results: The study included 89 patients: two patients in the PPI group, aged 69 and 71 years, and 87 patients in the non-PPI group, with a mean age of 62.3+/-13.6 years. PPI was required in 2.2% of patients. While the numbers of men and women in the pacemaker group were equal, the number of men in the non-pacemaker group was higher (male/female: 49/38). The PPI group had cardiopulmonary bypass times of 135 and 100 minutes, respectively, compared with 100+/-30 minutes in the non-PPI group, and aortic cross-clamp times of 75 and 88 minutes, respectively, compared with 70+/-20 minutes in the non-PPI group. At discharge, peak gradients decreased from 78 and 74 mmHg to 22 and 29 mmHg in the PPI patients (non-PPI: 78+/-30 to 25+/-12 mmHg), and mean gradients decreased from 44 and 45 mmHg to 10 and 14 mmHg (non-PPI: 45+/-15 to 12+/-6 mmHg). No in-hospital mortality or paravalvular leak was observed. Conclusions: In our experience, PPI after the Ozaki procedure was uncommon, while early echocardiographic and clinical outcomes remained favorable. Our findings are consistent with the available literature and highlight the need for vigilant postoperative conduction monitoring, especially in patients with baseline conduction disease or prolonged operative times.
