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

Hamamoto, Masaki; Kobayashi, Taira; Ozawa, Masamichi; Yoshimura, Kosuke

doi:10.5761/atcs.cr.16-00183

Cited by 29 publications

(21 citation statements)

References 10 publications

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“…Additionally, the stress-strain curves presented in Figure 4 show that sample groups (XD, HD, PD) behave similarly in the low-strain region, with significant divergences becoming evident as the maximum ultimate tensile strengths are approached. The early failure under cyclic loading seen in XD specimens ( Figure 6) may explain premature failures reported clinically [13]- [15].…”

Section: Discussionmentioning

confidence: 99%

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Collagen fibre orientation and dispersion govern ultimate tensile strength, stiffness and the fatigue performance of bovine pericardium

Whelan

Duffy

Gaul

et al. 2019

Journal of the Mechanical Behavior of Biomedical Materials

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The durability of bovine pericardium leaflets employed in bioprosthetic heart valves (BHVs) can significantly limit the longevity of heart valve prostheses. Collagen fibres are the dominant load bearing component of bovine pericardium, however fibre architecture within leaflet geometries is not explicitly controlled in the manufacture of commercial devices. Thus, the purpose of this study was to ascertain the influence of pre-determined collagen fibre orientation and dispersion on the mechanical performance of bovine pericardium. Three tissue groups were tested in uniaxial tension: cross-fibre tissue (XD); highly dispersed fibre-orientations (HD); or preferred-fibre tissue (PD). Both the XD and PD tissue were tested under cyclic loading at 1.5 Hz and a stress range of 2.7 MPa. The results of the static tensile experiments illustrated that collagen fibre orientation and degree of alignment significantly influenced the material's response. Whereby, there was a statistically significant decrease in material properties between the XD groups and both the PD and HD groups for ultimate tensile strength and stiffness (p<0.01). Furthermore, HD tissue had a stiffness of approximately 58% of the PD group, and XD tissue had a stiffness of approximately 18% of the PD group. The dynamic behaviour of the XD and PD groups was extremely distinct; for example a Weibull analysis indicated that the 50% probability of failure in specimens with fibres orientated perpendicular (XD) to the loading direction occurred at 375 cycles. Due to this failure, XD specimens survived less than 20% of the cycles completed by those in which fibres were aligned along the loading direction (PD). The results from this study indicate that fibre architecture is a significant factor in determining static strength and fatigue life in bovine pericardium, and thus must be incorporated in the design process to improve future device durability.

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Section: Discussionmentioning

confidence: 99%

“…has not yet been optimised [8]- [12]. Furthermore, it has been reported that the animal pericardial tissue used to construct the leaflets is a factor/cause of premature BHV failure [13]- [15].…”

Section: Introductionmentioning

confidence: 99%

Collagen fibre orientation and dispersion govern ultimate tensile strength, stiffness and the fatigue performance of bovine pericardium

Whelan

Duffy

Gaul

et al. 2019

Journal of the Mechanical Behavior of Biomedical Materials

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“…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.…”

Section: Commentmentioning

confidence: 99%

“…Subannular pannus formation was found in the explanted Trifecta valves in our reports and the previous literature. 10,11 Pannus forms as a result of surgical injury that leads to thrombus formation. 14 Patients who undergo Trifecta valve implantation can benefit from administration of postoperative warfarin for at least 3 months to prevent early leaflet thrombosis.…”

Section: Commentmentioning

confidence: 99%

“…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%).…”

mentioning

confidence: 99%

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

Kaneyuki

Nakajima

Asakura

et al. 2020

The Annals of Thoracic Surgery

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Background. The Trifecta valve (Abbott, St Paul, MN) has excellent hemodynamic performance with acceptable rates of freedom from structural valve degeneration. However, some recent studies have reported early Trifecta valve failure. Here, we report a case series of seven Trifecta valve failures with a review of the literature. Methods. Of 107 implantations of Trifecta bioprostheses between 2012 and 2014, we encountered seven Trifecta valve failures (6.5%). Failure of a 19-mm Trifecta valve occurred in 1 patient, failure of a 21-mm Trifecta valve occurred in 5 patients, and failure of a 23-mm Trifecta valve occurred in 1 patient. The mean duration of valve durability was 51 ± 16 months. The mean effective orifice area index on the first echocardiogram after Trifecta valve implantation was 0.96 ± 0.26. The mode of presentation was prosthetic valve stenosis in 3 patients and severe aortic regurgitation in 4 patients.

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Early surgical aortic bioprosthesis failure caused by cusp tear: A word of caution

Schaeffer

Berdajs

Reuthebuch

2020

Clinical Case Reports

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

Cited by 29 publications

References 10 publications

Collagen fibre orientation and dispersion govern ultimate tensile strength, stiffness and the fatigue performance of bovine pericardium

Collagen fibre orientation and dispersion govern ultimate tensile strength, stiffness and the fatigue performance of bovine pericardium

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

Early surgical aortic bioprosthesis failure caused by cusp tear: A word of caution

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