Early Degeneration Caused by Cusp Tear of First-Generation Trifecta Bioprosthesis

Early First-Generation Trifecta Valve Failure: A Case Series and a Review of the Literature

“…Trifecta valve failures have been reported in the literature based on a case report and a case series. [2][3][4][5][6][7][8][9][10][11][12][13] We reviewed 21 cases with early Trifecta valve failure from these reports. The mean age of patients was 69 AE 9 years and 43% were men.…”

“…Some patients had sudden onset of dyspnea and symptoms of acute congestive heart failure due to severe aortic regurgitation with cusp tears. 2,6,13 Valve durability ranged between 3 and 60 months, with a mean duration of 31 AE 18 months. Valve sizes that failed included 19 mm (n ¼ 3), 21 mm (n ¼ 7), 23 mm (n ¼ 8), and 25 mm (n ¼ 3).…”

“…20,21 Although more than onehalf of cases of early Trifecta valve failure can be managed with elective surgery, some cases require urgent surgery for severe aortic regurgitation due to cusp tears. 2,6,13 Therefore, the negative impact of early Trifecta valve failure should not be underestimated regardless of acceptable rates of structural valve degeneration.…”

“…In one study that reported the midterm 6-year outcomes of 710 Trifecta valves that were implanted in patients between 2007 and 2009 during the premarket approval phase, the rate of freedom from reoperation from structural valve degeneration was 97.3%. 1 Although some researchers have recently reported early Trifecta valve failure, [2][3][4][5][6][7][8][9][10][11][12][13] the number of reports that establish the mechanism of Trifecta valve failure and longterm durability and efficacy are still limited. We have experienced seven instances of early Trifecta valve failure at our single center among the 107 patients who underwent Trifecta valve implantation between 2012 and 2014 (6.5%).…”

Early failure of the Trifecta GT bioprostheses

“…There were several reports of early failure involving the first-generation Trifecta that were related to structural valve degeneration secondary to leaflet calcification, pannus formation, and cusps tear presenting less than 7 years after implantation. 1 , 2 , 3 , 4 Improvement in the design of Trifecta GT was implemented in response to those vulnerabilities, including Linx anticalcification technology and the Glide Technology for ease of implantation and minimal distortion during implantation. 3 However, despite these changes, we report here 3 cases of early failure involving the newer Trifecta GT.…”