Modes of Failure of Trifecta Aortic Valve Prosthesis

Overview

Journal Interact Cardiovasc Thorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2022 Mar 29

PMID 35348698

Authors

Pietro Giorgio Malvindi

Hassan Kattach

Suvitesh Luthra

Sunil Ohri

Affiliations

Soon will be listed here.

Abstract

Objectives: Several concerns have been recently raised regarding the durability of Trifecta prostheses. Different mechanisms of early failure were reported. Our aim was to study in a large population the modes of failure of Trifecta valves.

Methods: We conducted a retrospective analysis of patients who underwent surgical aortic valve replacement with a Trifecta prosthesis during the period 2010-2018. Details regarding the mode of failure and haemodynamic dysfunction were collected for patients who underwent reintervention for structural valve failure. The Kaplan-Meier method was used to calculate survival. Competing risk analysis was performed to calculate the cumulative risk of reintervention for structural valve failure.

Results: The overall population comprises 1228 patients (1084 TF model and 144 TFGT model). Forty-four patients-mean patients' age at the time of the first implant 69 (standard deviation: 12) years and 61% female-underwent reintervention for structural valve failure after a median time of 63 [44-74] months. The cumulative incidence of reintervention for structural valve failure was 0.16% (SE 0.11%), 1.77% (SE 0.38%) and 5.11% (SE 0.98%) at 1, 5 and 9 years, respectively. In 24/44 patients (55%), a leaflet tear with dehiscence at the commissure level was found intraoperatively or described by imaging assessment. The cumulative incidence of reintervention for failure due to leaflet(s) tear was 0.16% (SE 0.11%), 1.08% (SE 0.29%) and 3.03% (SE 0.88%) at 1, 5 and 9 years, respectively.

Conclusions: Leaflet(s) tear with dehiscence along the stent post was the main mode of early failure, up to 5 years, after Trifecta valves' implantation.

Citing Articles

Unusual cause of severe transvalvular eccentric jet AR: early structure valve deterioration of Trifecta valves by flail leaflet undergoing valve-in-valve transcatheter aortic valve replacement.

Chatlaong T, Kosum P, Tumkosit M, Limjareon T BMJ Case Rep. 2024; 17(2).

PMID: 38395470 PMC: 10895215. DOI: 10.1136/bcr-2023-256369.

Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review.

Angellotti D, Manzo R, Castiello D, Immobile Molaro M, Mariani A, Iapicca C Diagnostics (Basel). 2023; 13(10).

PMID: 37238215 PMC: 10217059. DOI: 10.3390/diagnostics13101731.

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