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Clinical And Echocardiographic Impact Of Trifecta™ Aortic Bioprosthesis: An Initial Single-centre Experience
Inna Kammerer, Mona Wiedemann, Falk-Udo Sack.
Department of Cardiac Surgery, Ludwigshafen, Germany.

Objectives: To face common issues such as high transvalvular pressure gradients after implanting small valve sizes and low effective orifice areas, which leads into manifestation of a patient prosthesis mismatch, the new Trifecta™ aortic valve was designed as a stented valve for supra-annular placement to re-duce the obstruction of the left ventricular outflow tract. The present study evaluated retrospective the early haemodynamic performance after implantation of the new valve. Methods: Between September 2010 and February 2013, 380 patients underwent an aortic valve replacement (AVR) with Trifecta™, Department of Cardiac Surgery, Germany. Prevalent cause of AVR was single aortic stenosis in 52%, insufficiency in 10% and combined pathology in 38%. Mean age at patients was 73 years (range 33-93), 58% of them were male. The mean preoperatively pressure gradient was 45mmHg with effective orifice area of 0.73cm2. The majority of patients were classified as NYHA Class III (78%). Results: The 30-day-mortality was 4% (n=16). The early postoperative hemodynamic date showed in Figure 1. Concomitant procedures were most frequently coronary artery bypass grafting (n=234), ablation of atrial fibrillation with LAA exclusion (n=67). There were 2 cardiac depending intraoperative deaths (0.52%), but not valve related. At discharge, there could not be determined any valve thrombosis or prosthesis failure. Conclusion: The Trifecta™ reveals excellent early haemodynamics over all valve sizes. Especially low gradients in small valves and large EOAs attest a satisfying outcome after implantation. Futher data is needed to investigate the stableness of these results in long time follow-up.

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