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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
FRANCO, Sergio et al. Mid term posoperative evaluation of aortic valve replacement with St. Jude TrifectaTM bioprosthesis. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.4, pp.449-456. Epub Nov 08, 2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.m22000185.
Background:
The St. Jude TrifectaTM valve is a latest generation bioprosthetic designed for supra annular aortic placement. The study main objective is the evaluation of the hemodynamic valve performance and the 3 to 72 months post implantation clinical status of the patients.
Method and materials:
Cohort study on patients older than 18 years, undergoing aortic valve replacement with St. Jude TrifectaTMbiological valve prosthesis between march 2012 and december 2018. The follow up was made by clinical evaluation and serial echocardiogram from 3 months to 6 years after surgery.
Results:
165 patients where included, 53.3% male. Mean age 69.6 years (30-90). The main indication for valve replacement was aortic stenosis (66.7%). Mean EuroSCORE II was 4.18 (0.56-24.35). Preoperative 60.6%, 29.6% and 9.69% of patients where in New York Heart Association functional class (NYHA) II, III and IV respectively. After the surgery, the mean effective orifice area index (IEOA) was 1.025 cm2/m2 for prosthesis N.o 19; 1.089cm2/m2 (prosthesis 21); 1.085 cm2/m2 (prosthesis 23) and 1.069 cm2/m2 (prosthesis 25). The mean transvalvular gradient was 3.08 mmHg at the immediate posoperative period, and the mean gradient at 3,6,12,24,36 and 72 months was 4.2, 5.7, 6.3, 7.1, 8.3 and 9.1 mmHg, respectively. 30 days mortality was 2.42%. None of the patients have a posoperative patient-prosthesis mismatch (PPM), neither thromboembolic events or endocarditis. There is no patients with re-operation for structural valve deterioration. After follow up, 83.6% of the patients are in NYHA I functional class.
Conclusion:
In this Study group, St. Jude Trifecta valve for aortic valve replacement provides excellent clinical (NYHA I, 83%) and hemodynamic outcomes (demostrated by no patients with re-operation for structural valve deterioration, a low post operative transvalvular gradients; IEOA that avoid PPM; excellent clinical and echocardiographic outcome during follow up (3 to 72 months).
Keywords : Valve prosthesis; Aortic; Aortic valve stenosis; Aortic insufficiency.
