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Excellent Long Term Outcomes Of Trifecta Aortic Valve Bio-prosthesis - A Single Centre Experience
Mukesh Karuppannan, David Rose, Anthony Walker, Amal Bose.
Blackpool Victoria Hospital, Blackpool, United Kingdom.

OBJECTIVE: The Trifecta bio-prosthesis is a bovine pericardial valve externally mounted on a titanium stent. Reports of early valve degeneration led to an evaluation of our experience with this valve and its long term outcomes.
METHODS: Patients undergoing aortic valve replacement (AVR) with the Trifecta valve between May 2011 and December 2019 at a single centre were included. The primary outcome was overall survival. Secondary outcomes included operative mortality and morbidity, aortic valve re-operations, and re-operation for structural valve deterioration. Echocardiographic outcomes were evaluated.
RESULTS: . The study included 419 Trifecta valve implants( 203 - first generation, 216 - GT series) . Operations included isolated AVR in 211 (50.35%) , AVR plus coronary artery bypass grafting in 165 (39.37%) , and AVR plus mitral valve operation in 43 (10.26%) .AVR by minimal access technique was used in 53 patients (12.64%).Early mortality rate was 3.81% (n=16).Overall survival at 1 year, 5 years and 10 years were 89.03%, 77.08% and 73.51% respectively(Figure). Overall freedom from aortic valve re-operation was 98.33% and 98.1% at 5 years and 10 years respectively(Figure). There were a total of 8 re-operations (median 3.4 years,IQR 3.46) with 2 re-operations in <1 year and 4 late re-operations , giving a total 10 year re-operation rate of 1.90%. Of these, 4 were for infective endocarditis, 1 was for paravavular leak and 3 were for structural valve degeneration (mean 4.52 years).Overall mean gradients were 6.9 5.2 mm Hg postoperatively and remained low at 10.5 6.4 mm Hg at 1 year.
CONCLUSIONS: Our results demonstrate that this valve can be safely implanted in the aortic position with excellent longterm durability and haemodynamics.


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