Early failures of Trifecta aortic bioprosthesis

Campisi, Salvatore; Camilleri, Lionel; Innorta, Andréa; Azarnoush, Kasra

doi:10.1016/j.jtcvs.2014.03.018

Cited by 29 publications

(24 citation statements)

References 7 publications

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“…[4][5][6] In these articles, the early SVD occurred at 3 months to 4 years (mean: 26 months) after the operation including our case. All the patients' ages at the time of AVR were over 65 years old, which were appropriate indication for bioprosthetic valves.…”

Section: Discussionmentioning

confidence: 67%

“…6) Cusp adhesion to the aortic wall could be caused by a foreign body reaction to polypropylene sutures used for aortotomy closure. 5) The Trifecta valve failure seems to be complex and multifactorial, as just described above. Cusp tear is the main cause of early SVD in pericardial valves.…”

Section: Discussionmentioning

confidence: 93%

“…Cusp tear could be caused by mechanical stress on the parastent sutures which promotes abrasion and rupture of the cusps, 4) and by peculiar pericardial fragility with no visible calcification. 5) Early calcification could be caused by an immunologic reaction. 6) Cusp adhesion to the aortic wall could be caused by a foreign body reaction to polypropylene sutures used for aortotomy closure.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pure Cusp Tear of Trifecta Bioprosthesis 2 Years after Aortic Valve Replacement

Hamamoto

Kobayashi

Ozawa

et al. 2017

ATCS

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Trifecta is a stented bioprosthetic heart valve with a bovine pericardial sheet externally mounted on a titanium stent. This valve is applied only for aortic valve replacement (AVR), providing excellent hemodynamics and extremely low incidence of structural valve deterioration (SVD). A 76-year-old woman presented with dyspnea on effort 24 months after AVR with a 21-mm Trifecta valve. Echocardiography revealed severe aortic regurgitation with prolapse of a cusp of Trifecta valve, which suggested that she developed acute heart failure due to early SVD. In the operation, Trifecta valve had a cusp tear near the commissure with circumferential fibrous pannus ingrowth only at the inflow side. There was neither calcification nor infection. The Trifecta valve was successfully replaced with a new porcine bioprosthesis.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pure Cusp Tear of Trifecta Bioprosthesis 2 Years after Aortic Valve Replacement

Hamamoto

Kobayashi

Ozawa

et al. 2017

ATCS

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show abstract

“…Interestingly, the Trifecta Durability Study (median follow-up, 0.9 years) reported 1 case of SVD requiring valve explantation but with no significant leaflet calcification. Few similar cases have been reported in the literature, 20 and only 1 additional case of early calcific SVD without tear has been reported. 21 An in-depth investigation of valve design and manufacturing is needed to clarify the underlying mechanism for this phenomenon.…”

Section: Discussionmentioning

confidence: 97%

“…Moreover, oversizing may explain a case of late fusion of a valve leaflet into the aortic wall reported in the literature. 20 The specific valve design carries a risk of noncoronary leaflet impingement in sutures, especially if the aortotomy is extended into the noncoronary sinus and supplementary hemostatic stitches are added after release of the aortic cross-clamp. Particular attention must be given to precise suturing of the aortotomy.…”

Section: Discussionmentioning

confidence: 99%