Fausto Biancari1, Antti Valtola2, Tatu Juvonen3, Annastiina Husso2, Sebastian Dahlbacka3, Teemu Laakso3, Maina P Jalava4, Tuomas Tauriainen5, Tuomas Ahvenvaara5, Eeva-Maija Kinnunen3, Matti Niemelä6, Timo Mäkikallio6, Markku Eskola7, Marko P O Virtanen7, Pasi Maaranen7, Stefano Rosato8, Vesa Anttila4, Antti Vento3, Juhani Airaksinen5, Peter Raivio3. 1. Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland; Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland. Electronic address: faustobiancari@yahoo.it. 2. Heart Center, Kuopio University Hospital, Kuopio, Finland. 3. Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland. 4. Heart Center, Turku University Hospital and Department of Surgery, University of Turku, Turku, Finland. 5. Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland. 6. Department of Internal Medicine, Oulu University Hospital, Oulu, Finland. 7. Heart Hospital, Tampere University Hospital, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland. 8. Istituto Superiore di Sanità, Rome, Italy.
Abstract
BACKGROUND: Recent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability. METHODS: This is a comparative analysis of the outcome of the Trifecta and Perimount Magna Ease bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017. RESULTS: Overall 2216 patients (mean age, 74.1±6.7 years; age<65 years, 8.9%; mean follow-up 3.8±2.1 years) received the Trifecta (851 patients) or the Perimount Magna Ease bioprosthesis (1365 patients). The rates of late mortality and prosthetic valve endocarditis were comparable in the study cohorts. At 7-year, the Trifecta cohort had significantly higher risk of repeat aortic valve replacement for structural valve failure (3.3% vs. 0%, adjusted SHR 2.224, 95%CI 1.044-4.737), repeat aortic valve replacement for any cause (3.6% vs. 0.4%, adjusted SHR 3.210, 95%CI 1.286-8.013) and repeat aortic valve replacement and/or prosthetic valve endocarditis (4.1% vs. 0.9%, adjusted SHR 3.210, 95%CI 1.286-8.013) compared to the Perimount Magna Ease cohort. Among 772 propensity score matched pairs, at 7-year, the Trifecta cohort had a higher risk of repeat aortic valve replacement for structural valve failure (5.7% vs. 0%, p=0.009). CONCLUSIONS: The Trifecta aortic bioprosthesis is associated with a higher occurrence of repeat aortic valve replacement for structural valve failure compared to the Perimount Magna Ease bioprosthesis. Further comparative studies with echocardiographic data on structural valve deterioration and longer follow-up are needed to confirm these findings.
BACKGROUND: Recent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability. METHODS: This is a comparative analysis of the outcome of the Trifecta and Perimount Magna Ease bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017. RESULTS: Overall 2216 patients (mean age, 74.1±6.7 years; age<65 years, 8.9%; mean follow-up 3.8±2.1 years) received the Trifecta (851 patients) or the Perimount Magna Ease bioprosthesis (1365 patients). The rates of late mortality and prosthetic valve endocarditis were comparable in the study cohorts. At 7-year, the Trifecta cohort had significantly higher risk of repeat aortic valve replacement for structural valve failure (3.3% vs. 0%, adjusted SHR 2.224, 95%CI 1.044-4.737), repeat aortic valve replacement for any cause (3.6% vs. 0.4%, adjusted SHR 3.210, 95%CI 1.286-8.013) and repeat aortic valve replacement and/or prosthetic valve endocarditis (4.1% vs. 0.9%, adjusted SHR 3.210, 95%CI 1.286-8.013) compared to the Perimount Magna Ease cohort. Among 772 propensity score matched pairs, at 7-year, the Trifecta cohort had a higher risk of repeat aortic valve replacement for structural valve failure (5.7% vs. 0%, p=0.009). CONCLUSIONS: The Trifecta aortic bioprosthesis is associated with a higher occurrence of repeat aortic valve replacement for structural valve failure compared to the Perimount Magna Ease bioprosthesis. Further comparative studies with echocardiographic data on structural valve deterioration and longer follow-up are needed to confirm these findings.
Authors: Stéphane Kermen; Juliette Strella; Arthur Aupart; Fabien Espitalier; Michel Aupart; Anne Bernard; Thierry Bourguignon Journal: JTCVS Open Date: 2022-05-29