The Prevalence of Patient-Prosthesis Mismatch Can Be Reduced Using the Trifecta Aortic Prosthesis

Hernández-Vaquero, Daniel; Díaz, Rocío; Pascual, Isaac; Rozado, José; Hera, Jesús M. de la; León, Víctor; Avanzas, Pablo; Martı́n, Marı́a; Iglesias, Daniel García; Calvo, David; Silva, Jacobo; Morís, César

doi:10.1016/j.athoracsur.2017.05.076

Cited by 14 publications

(13 citation statements)

References 18 publications

(56 reference statements)

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“…In the comparison of 339 patients with Trifecta valve and 963 patients with other bioprosthesis the PPM rates was found extremely low in the patients with Trifecta prosthesis. All differences; EOA, EOAI and mean transaortic gradients were statistically significant lower with Trifecta bioprosthesis (17) .…”

Section: How Can We Prevent the Development Of Ppm?mentioning

confidence: 78%

“…The Trifecta aortic valve, developed as a new generation bioprosthesis, decreased the incidence of PPM by approximately 10 times compared to other bioprostheses. PPM is almost eliminated in patients with aortic annulus 21 mm or greater with this new generation valve (17) .…”

Section: Resultsmentioning

confidence: 99%

“…EOAs of different types of prostheses are shown at Figure 2 (16) . Trifecta valve has 10-fold lower risk for the development of PPM (17) . If there is a risk of moderate to severe PPM, it is an option to implant prosthesis with a larger EOA (mechanical, prosthetic, homograft) or to perform aortic root enlargement to place larger valve prosthesis.…”

Section: How Can We Prevent the Development Of Ppm?mentioning

confidence: 99%

See 2 more Smart Citations

Management of Prosthesis-patient Mismatch After Aortic Valve Replacement

Demirsoy¹,

Demir²,

Uğur³

2019

ejcm

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Section: How Can We Prevent the Development Of Ppm?mentioning

confidence: 78%

Section: Resultsmentioning

confidence: 99%

Section: How Can We Prevent the Development Of Ppm?mentioning

confidence: 99%

See 1 more Smart Citation

Management of Prosthesis-patient Mismatch After Aortic Valve Replacement

Demirsoy¹,

Demir²,

Uğur³

2019

ejcm

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“…The study end point was reoperation, which limited the conclusions drawn about bioprosthesis failure rates. First, the valve failure rates may be lower than actual with this approach, as patients may be lost to valve-related mortality, 26 inoperable status, 19 out-of-province reoperations, and non-operative management of failing aortic valves rather than referral for reoperation. Indeed, studies that focus only on reoperation rates systematically underestimate the real incidence of SVD.…”

Section: Study Limitationsmentioning

confidence: 99%

6 Year Follow-up of Aortic Valve Reoperation Rates: Carpentier-Edwards Perimount vs St. Jude Medical Trifecta

Stubeda

Aliter

Gainer

et al. 2020

Preprint

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Background The Carpentier-Edwards Perimount valves have a proven track record in aortic valve replacement: good durability, hemodynamic performance, rates of survival, and infrequent valve-related complications and PPM. The St. Jude Medical Trifecta is a newer valve that has shown comparable early and midterm outcomes. Studies show reoperation rates of Trifecta are comparable to Perimount valves, with a few recent studies bringing into focus early SVD, and increased midterm SVD in younger patients. Given that midterm data for Trifecta is still sparse, we wanted to confirm the early low reoperation rates of Trifecta persist over time compared to Perimount. Methods The Maritime Heart Centre Database was searched for isolated AVR or AVR+CABG between January 2011 and December 2016. Primary end point of the study was all-cause reoperation rate. Results 711 Perimount and 453 Trifecta implantations were included. The reoperation hazards were determined for age: 0.96 (0.92-0.99, p=0.02), female (vs male): 0.35 (0.08-1.53, p=0.16), smoker (vs non-smoker): 2.44 (0.85-7.02, p=0.1), and Trifecta (vs Perimount): 2.68 (0.97-7.39, p=0.06). Kaplan-Meier survival analysis in subgroups-age < 60, age [?] 60, male, female, smoker, and non-smoker-showed Perimount having lower reoperation rates than Trifecta in patient younger than 60 (p=0.02) and those with smoking history (p<0.01). Conclusions The rates of reoperation of Perimount and Trifecta were comparable, with Trifecta showing higher rates in patients younger than 60 years, and current smokers. Continued diligence and further independent reporting of midterm reoperation and SVD rates of the Trifecta, including detailed echocardiographic follow up, are needed to confirm these findings.

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“…Among the currently available pericardial bioprostheses, the Trifecta valve (St. Jude Medical Inc, St Paul, MN) appears to have favorable hemodynamic characteristics [2], and in this study Hernandez-Vaquero and colleagues [3] calculated the prevalence and severity of prosthesis-patient mismatch to compare hemodynamic performance of the Trifecta bioprosthesis to the Mitroflow valve (Sorin Group, Milan, Italy). From Doppler echocardiographic studies 3 months postoperatively, investigators [4] found moderate or severe prosthesis-patient mismatch in approximately 20% of patients receiving a 19-mm trifecta valve compared with almost 60% of patients who received a similar sized Mitroflow prosthesis [4]. In addition, among patients receiving a 21-mm valve, the prevalence of moderate or severe prosthesis-patient mismatch in the Trifecta group was 4% compared with 48% of patients who had 21-mm Mitroflow valves.…”

Section: Invited Commentarymentioning

confidence: 99%