Early Structural Valve Degeneration of Trifecta Bioprosthesis

Fukuhara, Shinichi; Shiomi, Suzuna; Yang, Bo; Kim, Karen; Bolling, Steven F.; Haft, Jonathan W.; Tang, Paul C.; Pagani, Francis D.; Prager, Richard L.; Chetcuti, Stanley; Grossman, Paul; Patel, Himanshu J.; Deeb, G. Michael

doi:10.1016/j.athoracsur.2019.06.032

Cited by 68 publications

(82 citation statements)

References 13 publications

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“…These were common findings in the previous first-generation Trifecta studies. 2 In the present study, no aortic insufficiency was seen on the index intraoperative or follow-up echocardiograms. While no conclusions can be drawn from this small series, we postulate the unique design of the Trifecta GT might be contributing to the early failure.…”

Section: Discussioncontrasting

confidence: 40%

Early failure of the Trifecta GT bioprostheses

et al. 2020

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Section: Discussioncontrasting

confidence: 40%

Early failure of the Trifecta GT bioprostheses

et al. 2020

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“…The hazard function for reoperation with Trifecta implants was significantly higher among patients younger than 60 years of age and among patients who currently smoke. A recent study of midterm Trifecta durability has shown Trifecta was associated with high rates of SVD in patients younger than 65 years compared with non‐Trifecta group composed of Magna Ease (80.4%), Intuity (13.1%), Mitroflow (3.8%), and Avalus (2.7%), and the rate difference was also approximately threefold 18 . However, other studies have shown Perimount and Trifecta having similar rates of reoperation or reintervention.…”

Section: Discussionmentioning

confidence: 95%

Six‐year follow‐up of aortic valve reoperation rates: Carpentier‐Edwards Perimount versus St. Jude Medical Trifecta

et al. 2020

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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 low rates of valve-related complications and prosthesis-patient mismatch. 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 with Perimount valves, with a few recent studies bringing into focus early structural valve deterioration (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 with Perimount. Methods: The Maritime Heart Centre Database was searched for AVR between 2011 and 2016, inclusive. The primary endpoint of the study was all-cause reoperation rate. Results: In total, 711 Perimount and 453 Trifecta implantations were included. The reoperation hazards were determined for age: 0.96 (0.92-0.99; p = .02), female (vs. male): 0.35 (0.08-1.53; p = .16), smoker (vs. nonsmoker): 2.44 (0.85-7.02; p = .1), and Trifecta (vs. Perimount): 2.68 (0.97-7.39; p = .06). Kaplan-Meier survival analysis in subgroups-age <60, age ≥60, male, female, smoker, and nonsmokershowed Perimount having lower reoperation rates than Trifecta in patients younger than 60 (p = .02) and current smokers (p < .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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“…A recent study of mid-term Trifecta durability has shown Trifecta was associated with high rates of SVD in patients younger than 65 years compared to non-Trifecta group composed of Magna Ease (80.4%), Intuity (13.1%), Mitroflow (3.8%), and Avalus (2.7%), and the rate difference was also approximately 3-fold. 18 However, other studies have shown Perimount and Trifecta having similar rates of reoperation or reintervention. For Perimount Magna, reintervention rate was 1% at 10 years, 19 and cumulative incidences of explantation for endocarditis and SVD were 1.2% and 1.0% at 10 years.…”

Section: Discussionmentioning

confidence: 94%

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

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et al. 2020

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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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Early Structural Valve Degeneration of Trifecta Bioprosthesis

Cited by 68 publications

References 13 publications

Early failure of the Trifecta GT bioprostheses

Early failure of the Trifecta GT bioprostheses

Six‐year follow‐up of aortic valve reoperation rates: Carpentier‐Edwards Perimount versus St. Jude Medical Trifecta

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

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