title: Matched Comparison of Two Different Biological Prostheses for Complete Supra-annular Aortic Valve Replacement.
abstract: Objective The aim of this retrospective study was to evaluate the hemodynamic performance of the St. Jude Medical Trifecta (SJM Trifecta; St. Jude Medical, St Paul, Minnesota, United States) and the Carpentier-Edwards Perimount Magna Ease (CEPM Ease; Edwards Lifesciences, Irvine, California, United States) bioprostheses early postoperative and at 1 year. Methods From October 2007 to October 2008, a total of 61 consecutive patients underwent aortic valve replacement (AVR) with the CEPM Ease prosthesis. From a prospective cohort of 201 patients (March 2011 to January 2012) who received AVR with the SJM Trifecta valve, a matched group of 51 patients was selected. Matching was conducted 1:1 by ejection fraction, gender, age, and body surface area. A Hegar dilator was used to define the aortic tissue annulus diameter. Data were grouped on the basis of the patient's tissue annulus diameter (≤22 mm; 23-24 mm; ≥25 mm). Results Early postoperative and at 1 year mean pressure gradients (MPGs) in the various groups ranged from 7.2 ± 4.6 to 7.1 ± 2.4 mm Hg and from 10.0 ± 4.3 to 8.0 ± 2.8 mm Hg in the SJM Trifecta group and from 18.0 ± 5.0 to 12.1 ± 3.6 mm Hg and from 17.7 ± 4.5 to 11.8 ± 3.2 mm Hg in the CEPM Ease group, respectively. Likewise, effective orifice areas (EOAs) ranged from 1.7 ± 0.5 to 2.0 ± 0.5 cm(2) and from 1.5 ± 0.3 to 1.7 ± 0.4 cm(2) in the SJM Trifecta group and from 1.3 ± 0.5 to 1.9 ± 0.5 cm(2) and from 1.2 ± 0.3 to 1.8 ± 0.3 cm(2) in the CEPM Ease group, respectively. A marked left ventricular mass (LVM) regression across all annulus sizes was noted in both groups. Severe patient-prosthesis mismatch (PPM) was infrequent overall. Conclusion The SJM Trifecta valve showed lower MPGs early postoperative and at 1 year as well as higher EOA and effective orifice area index early postoperative. No significant differences were detected with regard to LVM regression and PPM.
authors.affiliation: Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Fiegl
authors.affiliation: Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
authors.forename: Marcus-Andre
authors.initials: MA
authors.lastname: Deutsch
authors.affiliation: Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany.
authors.forename: Ina-Christine
authors.initials: IC
authors.lastname: Rondak
authors.affiliation: Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
authors.forename: Ruediger
authors.initials: R
authors.lastname: Lange
authors.affiliation: Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Guenzinger
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography