Trifecta Versus Perimount Magna Ease Aortic Valve Prostheses.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
09 2020
Historique:
received: 11 09 2019
revised: 10 12 2019
accepted: 23 12 2019
pubmed: 18 2 2020
medline: 3 11 2020
entrez: 17 2 2020
Statut: ppublish

Résumé

Recent surgical bovine pericardial prostheses are widely used despite limited data on their long-term durability. This is a comparative analysis of the outcome of the Trifecta (Abbott, Abbott Park, IL) and Perimount Magna Ease (Edwards, Lifesciences Corp, Irvine, CA) bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017. Overall 2216 patients (mean age, 74.1 ± 6.7 years; age <65 years, 8.9%; mean follow-up, 3.8 ± 2.1 years) received the Trifecta (851 patients) or the Perimount Magna Ease (1365 patients) bioprostheses. The rates of late mortality and prosthetic valve endocarditis were comparable in the study cohorts. At 7 years the Trifecta cohort had a significantly higher risk of repeat aortic valve replacement for structural valve failure (3.3% vs 0%; adjusted subdistribution hazard ratio, 2.224; 95% confidence interval, 1.044-4.737), repeat aortic valve replacement for any cause (3.6% vs 0.4%; adjusted subdistribution hazard ratio, 3.210; 95% confidence interval, 1.286-8.013), and repeat aortic valve replacement and/or prosthetic valve endocarditis (4.1% vs 0.9%; adjusted subdistribution hazard ratio, 3.210; 95% confidence interval, 1.286-8.013) compared with the Perimount Magna Ease cohort. Among 772 propensity score-matched pairs, at 7 years the Trifecta cohort had a higher risk of repeat aortic valve replacement for structural valve failure (5.7% vs 0%, P = .009). The Trifecta aortic bioprosthesis is associated with a higher occurrence of repeat aortic valve replacement for structural valve failure compared with the Perimount Magna Ease bioprosthesis. Further comparative studies with echocardiographic data on structural valve deterioration and longer follow-up are needed to confirm these findings.

Sections du résumé

BACKGROUND
Recent surgical bovine pericardial prostheses are widely used despite limited data on their long-term durability.
METHODS
This is a comparative analysis of the outcome of the Trifecta (Abbott, Abbott Park, IL) and Perimount Magna Ease (Edwards, Lifesciences Corp, Irvine, CA) bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017.
RESULTS
Overall 2216 patients (mean age, 74.1 ± 6.7 years; age <65 years, 8.9%; mean follow-up, 3.8 ± 2.1 years) received the Trifecta (851 patients) or the Perimount Magna Ease (1365 patients) bioprostheses. The rates of late mortality and prosthetic valve endocarditis were comparable in the study cohorts. At 7 years the Trifecta cohort had a significantly higher risk of repeat aortic valve replacement for structural valve failure (3.3% vs 0%; adjusted subdistribution hazard ratio, 2.224; 95% confidence interval, 1.044-4.737), repeat aortic valve replacement for any cause (3.6% vs 0.4%; adjusted subdistribution hazard ratio, 3.210; 95% confidence interval, 1.286-8.013), and repeat aortic valve replacement and/or prosthetic valve endocarditis (4.1% vs 0.9%; adjusted subdistribution hazard ratio, 3.210; 95% confidence interval, 1.286-8.013) compared with the Perimount Magna Ease cohort. Among 772 propensity score-matched pairs, at 7 years the Trifecta cohort had a higher risk of repeat aortic valve replacement for structural valve failure (5.7% vs 0%, P = .009).
CONCLUSIONS
The Trifecta aortic bioprosthesis is associated with a higher occurrence of repeat aortic valve replacement for structural valve failure compared with the Perimount Magna Ease bioprosthesis. Further comparative studies with echocardiographic data on structural valve deterioration and longer follow-up are needed to confirm these findings.

Identifiants

pubmed: 32061588
pii: S0003-4975(20)30194-6
doi: 10.1016/j.athoracsur.2019.12.071
pii:
doi:

Types de publication

Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

879-888

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Fausto Biancari (F)

Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland; Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland. Electronic address: faustobiancari@yahoo.it.

Antti Valtola (A)

Heart Center, Kuopio University Hospital, Kuopio, Finland.

Tatu Juvonen (T)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Annastiina Husso (A)

Heart Center, Kuopio University Hospital, Kuopio, Finland.

Sebastian Dahlbacka (S)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Teemu Laakso (T)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Maina P Jalava (MP)

Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland.

Tuomas Tauriainen (T)

Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.

Tuomas Ahvenvaara (T)

Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.

Eeva-Maija Kinnunen (EM)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Matti Niemelä (M)

Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.

Timo Mäkikallio (T)

Department of Internal Medicine, Oulu University Hospital, Oulu, Finland.

Markku Eskola (M)

Heart Hospital, Tampere University Hospital, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.

Marko P O Virtanen (MPO)

Heart Hospital, Tampere University Hospital, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.

Pasi Maaranen (P)

Heart Hospital, Tampere University Hospital, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.

Stefano Rosato (S)

Istituto Superiore di Sanità, Rome, Italy.

Vesa Anttila (V)

Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland.

Antti Vento (A)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

Juhani Airaksinen (J)

Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.

Peter Raivio (P)

Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland.

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