Anas Mohamad Hashem, Ahmed Elkhapery, Amr Mohamed, Rupinder Buttar, Amani Khalouf, Mohamed Salah Mohamed, Faiz Abbas, Saif Ur Rehman, Mahmoud Eisa, Bipul Baibhav, Devesh Rai, Jeremiah P Depta
{"title":"5年随访期间Trifecta生物人工瓣膜结构性瓣膜退化和失效的比率和预测因素:单中心经验。","authors":"Anas Mohamad Hashem, Ahmed Elkhapery, Amr Mohamed, Rupinder Buttar, Amani Khalouf, Mohamed Salah Mohamed, Faiz Abbas, Saif Ur Rehman, Mahmoud Eisa, Bipul Baibhav, Devesh Rai, Jeremiah P Depta","doi":"10.4103/jcecho.jcecho_74_23","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF.</p><p><strong>Methodology: </strong>This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of <i>P</i> ≤ 0.05.</p><p><strong>Results: </strong>A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (<i>P</i> = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), <i>P</i> = 0.01. Furthermore, there was a significant increase from peak velocity to PV<sub>MRE</sub> (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], <i>P</i> < 0.01), an increase in pressure gradient (PG<sub>IPE</sub>) to PG<sub>MRE</sub> (MD ± SEM [1.70 ± 0.49], <i>P</i> < 0.01), and a decrease in Doppler velocity index (DVI<sub>IPE</sub>) to DVI<sub>MRE</sub> (MD ± SEM [-0.037 ± 0.01], <i>P</i> = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period.</p><p><strong>Conclusions: </strong>Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. These results corroborate with a previously published study suggesting a bad clinical outcome of Trifecta valve placement.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135815/pdf/","citationCount":"0","resultStr":"{\"title\":\"Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience.\",\"authors\":\"Anas Mohamad Hashem, Ahmed Elkhapery, Amr Mohamed, Rupinder Buttar, Amani Khalouf, Mohamed Salah Mohamed, Faiz Abbas, Saif Ur Rehman, Mahmoud Eisa, Bipul Baibhav, Devesh Rai, Jeremiah P Depta\",\"doi\":\"10.4103/jcecho.jcecho_74_23\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF.</p><p><strong>Methodology: </strong>This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of <i>P</i> ≤ 0.05.</p><p><strong>Results: </strong>A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (<i>P</i> = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), <i>P</i> = 0.01. Furthermore, there was a significant increase from peak velocity to PV<sub>MRE</sub> (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], <i>P</i> < 0.01), an increase in pressure gradient (PG<sub>IPE</sub>) to PG<sub>MRE</sub> (MD ± SEM [1.70 ± 0.49], <i>P</i> < 0.01), and a decrease in Doppler velocity index (DVI<sub>IPE</sub>) to DVI<sub>MRE</sub> (MD ± SEM [-0.037 ± 0.01], <i>P</i> = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period.</p><p><strong>Conclusions: </strong>Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. 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Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience.
Introduction: The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF.
Methodology: This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of P ≤ 0.05.
Results: A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (P = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), P = 0.01. Furthermore, there was a significant increase from peak velocity to PVMRE (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], P < 0.01), an increase in pressure gradient (PGIPE) to PGMRE (MD ± SEM [1.70 ± 0.49], P < 0.01), and a decrease in Doppler velocity index (DVIIPE) to DVIMRE (MD ± SEM [-0.037 ± 0.01], P = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period.
Conclusions: Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. These results corroborate with a previously published study suggesting a bad clinical outcome of Trifecta valve placement.