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Three-year haemodynamic performance of the St Jude Trifecta bioprosthesis

Abstract : OBJECTIVES To examine the haemodynamic performance of the St Jude Trifecta valve for aortic valve replacement (AVR) at 3 years after implantation. METHODS In a single-centre, prospective, observational, independent study, we enrolled 122 patients who had AVR using a Trifecta bioprosthesis in the July 2010–June 2011 period. A clinical and echocardiographic in-house follow-up was scheduled. RESULTS In our series, 14.7% of patients received a 19-mm, 28.7% had a 21-mm, 35.2% had a 23-mm and 21.3% had a greater-size prosthesis. There were no cases of operative mortality or of valve-related complications both early and at follow-up (except one sudden unexplained death). Completeness of the 3-year echocardiographic follow-up was 80% among survivors. The average mean transvalvular gradient (mTVG) at 3 years was 14.2, 10.8, 8.6, 7.1 and 6.8 mmHg (sizes 19 to 27/29, respectively). There was no statistically significant difference between average mTVGs measured immediately after implantation versus at the 3-year follow-up in the overall population. The average peak transvalvular gradient (pTVG) at 3 years was 25, 20, 16.8, 13.9 and 14.4 mmHg (sizes 19 to 27/29, respectively). The average indexed effective orifice area (iEOA) at 3 years was 0.8, 0.9, 1, 1.3 and 1.3 cm2/m2 (sizes 19–27, respectively). The rate of moderate patient–prosthesis mismatch (PPM) at 3 years was 15.7%; there were two instances of severe PPM (2.2%). All cases of PPM occurred in the 19, 21 and 23 mm size subgroups. CONCLUSIONS The Trifecta valve retains its excellent haemodynamic properties at the 3-year follow-up. The rate of PPM is considerably low
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01319951
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Submitted on : Monday, May 23, 2016 - 11:47:09 AM
Last modification on : Thursday, March 5, 2020 - 6:38:48 PM

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Vito Giovanni Ruggieri, Amedeo Anselmi, Céline Chabanne, Bernard Lelong, Erwan Flecher, et al.. Three-year haemodynamic performance of the St Jude Trifecta bioprosthesis. European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), 2016, 49 (3), pp.972--977. ⟨10.1093/ejcts/ezv211⟩. ⟨hal-01319951⟩

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