Early In-Vivo Hemodynamic Comparison of Supra-Annular Aortic Bioprostheses: Trifecta™ versus Perimount Magna Ease
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Amit Modi, Dimitrios Pousios, Syed Sadeque, Theodore Velissaris, Clifford Barlow, Steven Livesey, Geoffrey M. Tsang, Sunil K. Ohri Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton, UK |
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Background and aim of the study: The study aim was to compare early postoperative hemodynamic gradients after supra-annular implantation of the Trifecta™ and Perimount Magna Ease aortic bioprostheses. Methods: Between January 2010 and December 2011, a total of 235 patients (105 males, 130 females; mean age at surgery 73.8 ± 10.2 years) underwent supra-annular aortic valve replacement (AVR), with or without concomitant procedures. The patients were divided into 2 groups receiving either the Perimount Magna Ease (n = 117) or Trifecta (n = 118). Concomitant procedures were performed in 133 patients (56.6%), and 25 procedures (10.6%) were redos. Patients with postoperative severe left ventricular dysfunction and moderate to severe mitral regurgitation were excluded. Gradients were calculated pre-discharge using transthoracic echocardiography. Effective orifice area calculations were not performed. Data were collected retrospectively from hospital databases and analyzed using SPSS 17. Results: Both groups compared well for 14 variables. Group A had a higher number of redo operations and the |
patients were younger. Postoperative peak and mean gradients (in mmHg) for the Magna Ease group versus Trifecta group were: 19 mm valves, 33.5 ± 16 versus 24.7 ± 10 (p = 0.11) and 17.4 ± 6.5 versus 12.7 ± 4.4 (p = 0.05); 21 mm, 27.2 ± 9.1 versus 21.8 ± 7.2 (p = 0.001) and 13.8 ± 4.7 versus 10.7 ± 3.4 (p = 0.001); 23 mm, 25.6 ± 7.8 versus 20.1 ± 7.9 (p = 0.005) and 13 ± 4 versus 10.1 ± 4.3 (p = 0.002); 25 mm, 22.3 ± 7.8 versus 15.6 ± 5.1 (p = 0.01) and 12.8 ± 4.1 versus 8 ± 2.8 (p = 0.02). The overall mortality was 3.4%. The median hospital stay was nine days in both groups (p = 0.13). Mortality (p = 0.5), and incidences of perioperative stroke (p = 0.45), postoperative new-onset atrial fibrillation (p = 0.26) and permanent pacemaker implantation (p = 0.8) were similar in both groups. Conclusion: Early postoperative gradients were significantly lower in patients receiving Trifecta valves, although the long-term clinical outcome and durability of the valve will require further evaluation.The Journal of Heart Valve Disease 2014;23:325-332 |
| Early In-Vivo Hemodynamic Comparison of Supra-Annular Aortic Bioprostheses: Trifecta™ versus Perimount Magna Ease | |
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