Low Incidence of Structural Valve Degeneration With the Trifecta Aortic Valve Bioprosthesis.

Abstract Objectives: An ideal bioprosthetic heart valve would have excellent haemodynamic performance and a low rate of Structural Valve Degeneration (SVD). The objective of this study was to investigate the haemodynamic performance and incidence of reintervention due to SVD of the Trifecta aortic valve.Methods:Between 2012 to 2019, 2934 valve surgeries were performed in which 2185 were biological valves. Out of 2185 patients, only 399 patients had undergone Trifecta biological Aortic Valve Replacement (AVR). Three surgeons performed all aortic Trifecta valve surgeries. Operative mortality, incidence of reintervention and overall survival figures was calculated. Results: A total of 399 patients were included of which 260 (65.2%) were male. The mean (± SD) age was 73.4 ± 8.0 with 41 patients (10.3%) aged under 65 with 222 patients (55.6%) had isolated AVR and 176 (44.1%) had AVR combined with coronary artery bypass grafting and a single patient underwent aortic and mitral valve replacement. The mean (±SD) logistic EuroSCORE was 7.4 (±2.7). The median valve size used was 23mm. A total of 21 patients (5.3%) required a permanent pacemaker to be implanted. The 30-day mortality rate was 2.8% (n=11). The rate of structural valve degeneration was 0.3% and median follow-up was 782 days. Neither peak nor mean valve gradients were significantly different between year 1 vs. year 3 (peak gradient: 18.3±8.0 vs. 17.1±8.5, p=0.34; mean gradient: 9.8±4.6 vs. 8.7±4.6, p=0.16). Conclusions: Mid-term echocardiographic data showed a low rate of significant regurgitation and excellent gradients. Larger multicentre studies are required to validate these findings.