title: Pure Cusp Tear of Trifecta Bioprosthesis 2 Years after Aortic Valve Replacement.
abstract: Trifecta is a stented bioprosthetic heart valve with a bovine pericardial sheet externally mounted on a titanium stent. This valve is applied only for aortic valve replacement (AVR), providing excellent hemodynamics and extremely low incidence of structural valve deterioration (SVD). A 76-year-old woman presented with dyspnea on effort 24 months after AVR with a 21-mm Trifecta valve. Echocardiography revealed severe aortic regurgitation with prolapse of a cusp of Trifecta valve, which suggested that she developed acute heart failure due to early SVD. In the operation, Trifecta valve had a cusp tear near the commissure with circumferential fibrous pannus ingrowth only at the inflow side. There was neither calcification nor infection. The Trifecta valve was successfully replaced with a new porcine bioprosthesis.
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hamamoto
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
authors.forename: Taira
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ozawa
authors.affiliation: Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hatsukaichi, Hiroshima, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Yoshimura
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001705:Bioprosthesis; D020878:Device Removal; D018618:Echocardiography, Doppler, Color; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
keywords: Trifecta; aortic valve replacement; pericardial bioprosthesis; structural valve deterioration