title: Mid-term durability of the Trifecta bioprosthesis for aortic valve replacement.
abstract: To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR).
  
  
  
  We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively.
  
  
  
  Operative mortality was 3.8%; 2.7% in patients receiving isolated AVR. There were 5 valve-related early reoperations, including 1 for infective prosthetic endocarditis and 4 for nonstructural valve dysfunction. The global rate of severe patient-prosthesis mismatch was 1.26%. Overall 5-year survival was 74.9%, and freedom from valve-related death was 97.8%. The majority of deaths attributed to the valve were due to unknown causes. We observed 6 SVD events at 3.4 ± 1.6 years after surgery. At 5 years, the actuarial freedom from SVD was 98% ± 0.9% (n = 6), freedom from reintervention for SVD was 98% ± 0.9% (n = 5, including 2 transcatheter valve-in-valve), and freedom from open reoperation for SVD was 98.9% ± 0.6%. The 5-year freedom from prosthetic endocarditis was 97.7% ± 0.7% (n = 12, 6 requiring reoperation). There was 1 case of late NSVD (5-year freedom, 99.8% ± 0.2%). Freedom from hemorrhagic events was 98.6% ± 0.5% (86% occurring in patients on anticoagulants); there were no thromboembolic events at follow-up.
  
  
  
  The Trifecta bioprosthesis is a reliable device for AVR. We confirm excellent immediate hemodynamic properties and a very low rate of patient-prosthesis mismatch. The absolute number of SVD cases observed remains limited; nevertheless, their timing, pathological characteristics, and clinical presentation mandate continued follow-up.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France. Electronic address: amedeo.anselmi@alice.it.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Anselmi
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Vito Giovanni
authors.initials: VG
authors.lastname: Ruggieri
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Lelong
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Flecher
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Corbineau
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Langanay
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Verhoye
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Leguerrier
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors
keywords: aortic valve replacement; durability; outcomes; trifecta