Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience

Authors

Anas Mohamad Hashem, Rochester Regional HealthFollow
Ahmed Elkhapery, Rochester Regional HealthFollow
Amr Mohamed, Department of Cardiovascular, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Rupinder Buttar, Rochester Regional HealthFollow
Amani Khalouf, Rochester Regional HealthFollow
Mohamed Salah Mohamed, Rochester Regional HealthFollow
Faiz Abbas, Rochester Regional HealthFollow
Saif Ur Rehman, Rochester Regional HealthFollow
Mahmoud Eisa, Rochester Regional HealthFollow
Bipul Baibhav, Rochester Regional HealthFollow
Devesh Rai, Rochester Regional HealthFollow
Jeremiah P. Depta, Rochester Regional HealthFollow

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Journal of Cardiovascular Echography

Abstract

Introduction: The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF.

Methodology: This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of P ≤ 0.05.

Results: A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (P = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), P = 0.01. Furthermore, there was a significant increase from peak velocity to PVMRE (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], P < 0.01), an increase in pressure gradient (PG_IPE) to PG_MRE (MD ± SEM [1.70 ± 0.49], P < 0.01), and a decrease in Doppler velocity index (DVI_IPE) to DVI_MRE (MD ± SEM [-0.037 ± 0.01], P = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period.

Conclusions: Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. These results corroborate with a previously published study suggesting a bad clinical outcome of Trifecta valve placement.

First Page

7

Last Page

13

DOI

10.4103/jcecho.jcecho_74_23

Volume

34

Issue

1

Publication Date

1-1-2024

PubMed ID

38818315

Recommended Citation

Hashem, A. M., Elkhapery, A., Mohamed, A., Buttar, R., Khalouf, A., Mohamed, M. S., Abbas, F., Rehman, S. U., Eisa, M., Baibhav, B., Rai, D., & Depta, J. P. (2024). Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience. Journal of Cardiovascular Echography, 34 (1), 7-13. https://doi.org/10.4103/jcecho.jcecho_74_23