Structural valve deterioration after aortic valve replacement with the Trifecta valve.
Aged
Aged, 80 and over
Aortic Valve
/ surgery
Aortic Valve Insufficiency
/ surgery
Aortic Valve Stenosis
/ surgery
Bioprosthesis
Echocardiography
Female
Heart Valve Prosthesis
Humans
Male
Middle Aged
Prosthesis Design
Retrospective Studies
Time Factors
Transcatheter Aortic Valve Replacement
/ methods
Bioprosthetic dysfunction
Structural valve deterioration
Surgical aortic valve replacement
Journal
Interactive cardiovascular and thoracic surgery
ISSN: 1569-9285
Titre abrégé: Interact Cardiovasc Thorac Surg
Pays: England
ID NLM: 101158399
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
03
06
2020
revised:
24
08
2020
accepted:
16
09
2020
pubmed:
23
11
2020
medline:
17
7
2021
entrez:
22
11
2020
Statut:
ppublish
Résumé
Despite promising short- and mid-term results for durability of the Trifecta valve, contradictory reports of early structural valve deterioration (SVD) do exist. We investigated the incidence of SVD after surgical aortic valve replacement (SAVR) with the Trifecta in our single-centre experience. Data of 347 consecutive patients (mean age 71.6 ± 9.5 years, 63.4% male) undergoing SAVR with the Trifecta between 2011 and 2017 were analysed. Clinical and echocardiographic reports were obtained with a median follow-up of 41 months (1114 patient years). Isolated SAVR was performed in 122 patients (35.2%), whereas 225 patients (64.8%) underwent concomitant procedures. The median EuroSCORE II was 4.0 (0.9; 7.1) and 30-day mortality was 3.7% (n = 13). Kaplan-Meier estimates for the freedom of overall mortality at 1, 5 and 7 years were 88.7 ± 1.7%, 73.7 ± 2.6% and 64.7 ± 4.2%, respectively. SVD was observed in 25 patients (7.2%) with a median time to first diagnosis of 73 months. Freedom of SVD was 92.5 ± 0.9% at 5 years and 65.5 ± 7.1% at 7 years. Thirteen patients underwent reintervention for SVD (6 re-SAVR, 7 valve-in-valve), resulting in a freedom of reintervention for the SVD of 98.5 ± 1.1% at 5 years and 76.9 ± 6.9% at 7 years. We herein report one of the highest rates of SVD after SAVR with the Trifecta. These data indicate that the durability of the prosthesis decreases at intermediate to long-term follow-up, leading to considerable rates of reintervention due to SVD.
Identifiants
pubmed: 33221889
pii: 5998374
doi: 10.1093/icvts/ivaa236
pmc: PMC8906717
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
39-46Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
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