Jude Medical Trifecta valve (St
Supra-annular placement of an aortic bioprosthesis is one approach to optimize the haemodynamic result of an aortic valve replacement. With this concept, the internal valve diameter should theoretically be equal to the tissue annulus diameter and thus achieve an optimal haemodynamic performance with no obstruction of the blood flow.
Trifecta™ biological aortic valve prosthesis
N2 - Background: The St Jude Medical Inc (St Paul, Minn) Trifecta valve is a novel aortic biological prosthesis that incorporates several design features, including a true supra-annular sewing cuff, a stent design that maximizes valve hemodynamics while minimizing leaflet stresses, and an ethanol-based anticalcification technology. This study establishes the safety and early clinical and hemodynamic performance of the Trifecta valve. Methods: The Trifecta bioprosthesis was implanted in 1014 eligible patients between 2007 and 2009 at 31 centers. The mean age of the population was 72.5 ± 9.0 years, of whom 650 (64.1%) were male and 364 (35.9%) were female. Eighty-two subjects (8.1%) had undergone previous open surgery. Indications for aortic valve replacement surgery included stenosis in 556 patients (54.8%), regurgitation in 61 patients (6.0%), and mixed pathology in 397 patients (39.2%). Results: The overall follow-up included 844.3 late patient-years. Early (≤30 day) mortality occurred in 18 patients (1.8%), and there were 23 late (≥31 days) deaths yielding a linearized mortality rate of 2.72% per late patient-year. There were 27 early thromboembolic events, including 8 (0.8%) strokes, 17 (1.7%) reversible neurologic events, and 2 (0.2%) systemic embolic events. There were no instances of early valve thrombosis, endocarditis, or clinically significant hemolysis. There were 16 late thromboembolic events (linearized rate of 1.90% per year of follow-up), including 4 strokes and 12 reversible neurologic events. In total, there were 5 late valve explants, including 1 structural deterioration and 4 prosthetic valve endocarditis cases. Overall, freedom from valve explant was 99.4% at 2 years. At the time of discharge, average mean gradients ranged from 9.3 to 4.1 mm Hg and effective orifice area ranged from 1.58 to 2.50 cm2 for valve sizes 19 to 29 mm, respectively. Conclusions: The St Jude Medical Trifecta valve is a unique pericardial bioprosthesis with design elements that provide excellent hemodynamic performance while providing ease of implantation. Long-term follow-up continues to confirm the promising results of this innovative bioprosthesis.
From July 2010 to September 2012, a total of 200 consecutive patients underwent aortic valve replacement with the Trifecta valve in our institution. All intraoperative and postoperative data were prospectively collected. Mean EuroSCORE II was 3.98%. Echocardiography was performed at discharge in all patients.
The Trifecta aortic bioprosthesis (St
We proceeded to the resection of the native valve, with decalcification of the ring in the usual manner. The size of the prosthesis was measured with standard Trifecta sizers. The intra-annular end of the sizer should enter into the aortic annulus tightly. The supra-annular end of the sizer is designed to reproduce the valve in order to check the supra-annular position regarding the coronary ostia. As explained later, it is important to avoid oversizing.
Jude Medical™ Trifecta™ valve with Glide ..
The primary study endpoint was the clinical and haemodynamic performances of the Trifecta bioprosthesis in the early postoperative period. It included major adverse prosthesis-related events according to the guidelines for reporting mortality and morbidity after cardiac valve intervention . Moreover, we also reported transvalvular gradients, effective orifice area (EOA) and prosthesis-patient mismatch (PPM) determined by echocardiography.
Trifecta Bioprosthesis Heart Valve Flashcards | Quizlet
The Trifecta valve is made with bovine pericardium and is designed for supra-annular placement, obtaining the benefits mentioned above. Beyond that, its valve design includes pericardial tissue leaflets attached to the exterior of the valve stent intending to increase the opening area.
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A consecutive series of patients undergoing aortic valve replacement from July 2010 to September 2012 was analysed prospectively. The only inclusion criterion was the need for a biological aortic valve replacement; there were no exclusion criteria. All stented biological aortic valves implanted in this period were Trifecta valves.
Surgical aortic pericardial valves | Edwards Lifesciences
From the clinical point of view, early mortality at 30 days was 2.5% (n = 5), which is a low rate compared with other studies [, , ]. Causes of death were considered valve-related only in 1 patient, who died 7 days after discharge, of unknown reasons. All postoperative unexplained or undefined events or deaths were considered valve-related. Only 1 patient (0.5%) had significant aortic insufficiency because of prosthetic endocarditis. After antibiotic treatment, the prosthesis was replaced with another Trifecta valve. The remaining 99.5% had trivial or no aortic insufficiency. In our experience, the clinical performance of the Trifecta valve is perfectly comparable with the other stented biological valves.