Five Year Experience Of Haemodynamic Performance Of The St.jude Medical Trifecta Aortic Bioprosthesis
Benjamin Adams, Jacob Chacko, Joy Edlin, Shirish Ambekar, John Yap, Kulvinder Lall.
Barts Heart Centre, London, United Kingdom.
OBJECTIVE: The St. Jude Medical Trifecta aortic supra-annular bioprosthesis is regarded as the next generation in pericardial stented tissue valves. The unique design of tissue leaflets attached to the exterior of the valve stent provides unrivalled in-vivo mean gradients and haemodynamics. The aim of this prospective study was to evaluate the five-year haemodynamic performance of the Trifecta valve.
METHODS: Four hundred and nineteen consecutive patients undergoing aortic valve replacement using the St. Jude Medical Trifecta valve at a single UK centre over a five-year period were included in this study. Patients undergoing concomitant cardiac procedures were included. All implanted valves were 19, 21, 23, 25, 27 & 29 mm in size. Assessment of haemodynamic function was carried out using transthoracic echocardiography pre-operatively and at follow-up, as well as transoesophageal echocardiography intra-operatively.
RESULTS: The study population consisted of 419 patients (245 male, 174 female). Mean age was 72.7±9.3 years. Implanted valve sizes were 19mm (n=27), 21mm (n=124), 23mm (n=147), 25mm (n=95), 27mm (n=13) and 29mm (n=1). Overall mean post-operative pressure gradients were 9.27±5.3mmHg (mean) and 17.5±9.45mmHg (peak). Subgroups mean post-operative pressure gradients were 12.5±3.9mmHg, 10.5±7.4mmHg, 8.8±4.3mmHg, 8.0±3.7mmHg,7.5±3.7mmHg, 6.86±0mmHg, for the 19, 21, 23, 25,27 and 29mm cohort respectively. Overall mean post-operative left ventricular ejection fraction was 55.1±12.1%. Overall mean effective orifice area was 1.81±0.55cm2.
CONCLUSIONS: These results of our experience demonstrate excellent haemodynamic performance of the Trifecta bioprosthetic valve.
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