Clinical and echocardiographic outcomes after implantation of the Trifecta aortic bioprosthesis: an initial single-centre experience

Schlarb, Dominik; Schneider, Stefan R.B.; Sindermann, Jürgen R.; Hoffmeier, A.; Kaleschke, Gerrit; Martens, Sven; Rukosujew, Andreas

doi:10.1093/icvts/ivs460

Cited by 34 publications

(34 citation statements)

References 14 publications

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“…For this evaluation, data of the 21 mm LDP was not considered, due to the low number of cases. Data for valve-sizes 23 mm and 25 mm were comparable to data published for the SJM Trifecta regarding pressure gradients, EOA and EOAI [7, 12]. In contrast, data for size 27 mm showed inferior results than the SJM Trifecta.…”

Section: Discussionsupporting

confidence: 75%

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Clinical outcome and hemodynamic behavior of the Labcor Dokimos Plus aortic valve

Christ

Zhigalov

Konertz

et al. 2016

J Cardiothorac Surg

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BackgroundThe Labcor Dokimos Plus (LDP) is a stented externally mounted pericardial aortic bioprosthesis, which was recently introduced in Europe. Aims of the study are evaluation of operative and postoperative results as well as hemodynamic performance.MethodsOne hundred consecutive patients with a mean age of 65.9 ± 10.7 years (range 35–87) and a mean EuroSCORE II of 3.1 ± 3.9 (range 0.67–24.5) underwent aortic valve replacement with the LDP. Mean valve-size was 25.2 ± 1.7 mm. Concomitant procedures were performed in 34% of the cases. Postoperative clinical data were analyzed and hemodynamic performance of the prostheses was evaluated by transthoracic echocardiography. Clinical follow-up was 100%, echocardiographic follow-up was 93% complete.ResultsIntraoperatively no peculiarities occurred. Mean cross clamp times for isolated and complex procedures were 74.5 ± 20.0 min and 103.7 ± 37.1 min, respectively. Patients were extubated after a mean of 9.4 ± 15.8 h. There were no perioperative strokes. Bleeding events occurred in 4 patients. 30-day-mortality was 2%. One case of early endocarditis occurred. Echocardiography showed maximum and mean pressure gradients of 18.1 ± 6.4 and 9.6 ± 3.7 mmHg, respectively. Correspondingly to valve sizes 21, 23, 25 and 27 mm, mean pressure gradients were 17.3, 9.5, 8.5 and 10.2 mmHg, effective orifice areas were 1.92, 1.79, 2.0, 2.16 cm2 and indexed effective orifice areas were 1.08, 0.95, 0.99 and 1.01 cm2/m2, respectively. No relevant regurgitations occurred.ConclusionsThe LDP showed operatively no peculiarities and a satisfactory clinical outcome with low perioperative morbidity and mortality. The hemodynamic performance of the implanted valve sizes was satisfactory.

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Section: Discussionsupporting

confidence: 75%

“…The postoperative course of most patients was uneventful. However, the need of permanent pacemakers in six patients was slightly higher than reported for the SJM Trifecta [7]. Moreover, there were eight patients requiring temporary dialysis postoperatively.…”

Section: Discussionmentioning

confidence: 75%

Clinical outcome and hemodynamic behavior of the Labcor Dokimos Plus aortic valve

Christ

Zhigalov

Konertz

et al. 2016

J Cardiothorac Surg

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“…These other studies were conducted in different patient populations, less at risk for requiring reoperation for valve deterioration during their lifetime than patients with congenital heart disease, and they examined the use of the valve in the aortic position for which the valve prosthesis was designed. Dell’Aquila and colleagues [13] compared mean transvalvular gradients of the Trifecta valve with the Mosaic aortic bioprosthesis (Medtronic, Minneapolis, MN) and the Perimount valve among adult patients undergoing aortic valve replacement and found substantially reduced gradients associated with the Trifecta valve. Ruggieri and colleagues [14] also published their 3-year results using the Trifecta valve for aortic valve replacement in adult patients and found very low peak transvalvular gradients, even out to 3 years.…”

Section: Commentmentioning

confidence: 99%

Pulmonary Valve Replacement With a Trifecta Valve Is Associated With Reduced Transvalvular Gradient

Gulack

Benrashid

Jaquiss

et al. 2017

The Annals of Thoracic Surgery

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Background Outcomes after surgical pulmonary valve replacement (PVR) in patients with congenital cardiac disease are limited by long-term valve deterioration, which may be hastened by turbulent flow. The use of the Trifecta valve (St. Jude Medical, Little Canada, MN) at our institution (Duke University Medical Center, Durham, NC) appears to result in low postimplantation transvalvular gradients. This study was performed to compare the early transvalvular gradient associated with the Trifecta valve with that associated with two other valves commonly used for PVR. Methods We performed a single institution review of patients undergoing PVR with the Perimount valve (Edwards Lifesciences, Irvine, CA), the Biocor valve (St. Jude Medical), or the Trifecta valve between November 1993 and January 2014. Multivariable linear regression modeling was used to determine the adjusted association between valve type and transvalvular gradient as determined by early postoperative echocardiography. Results A total of 186 patients met study criteria; 54 (29%) received a Biocor valve, 87 (47%) received a Perimount valve, and 45 (24%) received a Trifecta valve. There were no baseline differences among the groups, but the peak transvalvular gradient was significantly decreased among patients with the Trifecta valve. After adjustment for age, valve size, patients’ weight, and time to the assessment, as compared with the Trifecta valve, the Biocor valve was associated with a 57% higher peak valve gradient (p < 0.01), whereas the Perimount valve was associated with a 26% higher peak valve gradient (p = 0.04). Conclusions PVR for congenital heart disease with the Trifecta bioprosthetic valve is associated with a reduced early transvalvular gradient. This finding may be associated with reduced valve deterioration over time.

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“…Гемодинамические характеристики рассматри-ваемых моделей также достоверно не различаются и сопоставимы с зарубежными аналогами [13,14]. Несмотря на то что в нашем исследовании мы ни в одном случае не наблюдали проблемы несоот-ветствия протез -пациент (площадь аортального отверстия, индексированная к ППТ, во всех случа-ях была больше 1 см 2 /м 2 ), при проведении регрес-сионного анализа отмечается прямая взаимосвязь между пиковым транспротезным градиентом и индексом массы тела.…”

Section: обсуждение результатовunclassified

Stented Bioprosthesis in Aortic Position: Analysis of the Early Results Based on a Retrospective Study

Караськов¹,

Астапов²,

Демидов³

et al. 2016

Kompleks. probl. serdečno-sosud. zabol.

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1 Федеральное государственное бюджетное учреждение «Научно-исследовательский институт патологии кровообращения имени академика Е. Н. Мешалкина» Минздрава РФ. Новосибирск, Россия 2 Федеральное государственное бюджетное учреждение «Федеральный центр высоких медицинских технологий». Калининград, РоссияЦель. Ретроспективный анализ непосредственных результатов лечения данной категории пациентов позволит сформиро-вать представление о необходимости проведения проспективного рандомизированного исследования.Материалы и методы. Анализу подвергнуты результаты 411 операций, выполненных больным с аортальным стенозом. I группа -227 больных с имплантированным в аортальную позицию биопротезом «Юнилайн», II группа -184 пациента с импланти-рованным каркасным биопротезом «БиолАБ».Результаты. Послеоперационная летальность в I группе составила 1,8 % (4 пациента), во II группе -2,7 % (5 пациентов) (р=0,8). для определения факторов, имеющих связь с градиентом давления на аортальном протезе, был проведен регрессионный анализ. В I группе выявлена взаимосвязь между пиковым транспротезным градиентом давления (Птгд) и индексом массы тела (р=0,001). Во II группе выявлена взаимосвязь между Птгд и ударным объемом левого желудочка, индексом массы тела, диаметром протеза. В I группе в периоперационном периоде потребовал реимплантации клапана 1 (0,4 %) пациент. Причина дисфункции -ятрогенное повреждение протеза. Во II группе всего зафиксировано 3 (1,6 %) ранних дисфункции протеза, из них 1 (0,5 %) -ятро-генная и 2 (1 %) -обусловленные непосредственно протезом.Выводы. Проспективное рандомизированное контролируемое исследование, проведенное в продолжительном периоде в нескольких клиниках одновременно, позволит более объективно оценить преимущества и недостатки протезов и определить перспективы развития этого направления в России.Ключевые слова: пороки клапанов сердца, протезирование аортального клапана, биологический протез. Purpose. Retrospective analysis of the immediate results of the treatment of these patients will form an idea of the need for a prospective randomized study. STENTED BIOPROSTHESIS IN AORTIC POSITION: ANALYSIS OF THE EARLY RESULTS BASED ONMaterials and methods. Are analyzed the results of 411 operations performed in patients with aortic stenosis. the first group -227 patients with implanted bioprosthesis in the aortic position UniLine, the second group -184 patients with implanted stented bioprosthesis Biolab.Results. Postoperative mortality in group I was 1.8 % (4 patients), in group II -2.7 % (5 patients) (p=0.8). to determine the factors that have a connection to the pressure gradient in the aortic prosthesis, regression analysis was performed. In group I, the relationship between the peak pressure gradient and body mass index (p = 0.001). In group II, the relationship peak pressure gradient and stroke volume of the left ventricle, body mass index and diameter of the prosthesis. In group I in the perioperative period required reimplantation valve 1 (0.4 %) patient. Reason dysfunction -iatrogenic damage to the prosthesis. In ...

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Clinical and echocardiographic outcomes after implantation of the Trifecta aortic bioprosthesis: an initial single-centre experience

Abstract: The initial experience with the Trifecta valve bioprosthesis shows excellent outcomes with favourable early haemodynamics. Further studies with longer follow-up are needed to confirm those preliminary results.

Cited by 34 publications

References 14 publications

Clinical outcome and hemodynamic behavior of the Labcor Dokimos Plus aortic valve

Clinical outcome and hemodynamic behavior of the Labcor Dokimos Plus aortic valve

Pulmonary Valve Replacement With a Trifecta Valve Is Associated With Reduced Transvalvular Gradient

Stented Bioprosthesis in Aortic Position: Analysis of the Early Results Based on a Retrospective Study

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