Mid-term clinical and health-related quality of life outcomes for the Trifecta bioprosthesis

Purkayastha, Biswarup; Khan, Wasim Hayat; Saha, Atanu; Das, Debasis; Kapoor, Lalit; Das, Mrinalendu; Narayan, Pradeep

doi:10.1007/s12055-021-01166-5

Cited by 1 publication

(2 citation statements)

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“…8 Apart from reduced LV mass regression and decreased coronary flow reserve, severe PPM has also been associated with poor short-and long-term survival as well as an increase in cardiac and all-cause mortality. [8][9][10] However, since PPM is defined as iEOA (EOA/BSA), it is therefore not just the size of the valve but also the BSA that contributes to PPM. 5 Thus, the same size valve may cause significant PPM and poor hemodynamics in one patient, but can provide satisfactory results in another.…”

Section: Discussionmentioning

confidence: 99%

“…9 Even moderate PPM leads to reduced LV mass regression as well as significantly reduced coronary flow reserve. 10 Hence, PPM must be avoided, and aortic root enlargement is an important component in the armamentarium of the cardiac surgeon. A similar study carried out in Japanese patients with small aortic roots has shown that aortic root enlargement has not been associated with increased in-hospital and 30-day mortality or other adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Are small-sized mechanical valves adequate for patients with small aortic roots?

Pandey

Saha

Jha

et al. 2022

Asian Cardiovasc Thorac Ann

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Aim Concerns have been raised over patient outcomes following implantation of small aortic valves (size: 19 and 17 mm). However, in patients with a smaller body surface area, these valves may be adequate. The aim of th study was to assess the hemodynamic and functional performance of these valves and their impact on clinical outcomes in patients with a small aortic root. Material and methods This was a prospective observational study that included all consecutive patients undergoing aortic valve replacement (AVR) with a small-sized aortic valve over a 3-year period. Patients were followed up at 1 week, 6 weeks, and 1 year. Functional and clinical evaluation along with echocardiography was carried out for hemodynamic assessment. In-hospital mortality and hemodynamic outcomes at 1-year follow-up were recorded. Results Isolated AVR with a size 17 mm valve was carried out in 15 (25%) and with a 19 mm valve in 45 (75%) patients. The mean annular size was 19.12 ± 2.03 mm. The mean indexed effective orifice area was 1.08 ± 0.16 cm2/m2. Satisfactory decrease in peak and mean trans-prosthetic gradient were evident (peak gradient preoperatively was 92.15 ± 26.2 mmHg, and 25.68 ± 12.28 mmHg at 1 year, mean gradient was 55.31 ± 17.41 mmHg preoperatively and 13.71 ± 7.39 mmHg at 1 year). The functional status of patients also showed significant improvement post AVR. Left ventricular ejection fraction pre-operatively was 59.67% ± 10.38% and 59.57% ± 7.98% at 1-week, 59.15% ± 8.17% at 6 weeks, and 59.59% ± 7.48% at 1 year. Conclusion When confronted with a small aortic root, AVR with a small-sized prosthesis provides a satisfactory hemodynamic and functional outcome. In patients with small body surface area, implantation of a small-sized valve is a viable option.

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