Rates of structural valve deterioration and failure of trifecta bioprosthetic valve over a 5-year follow-up period: a single-center experience

SESSION TITLE: Cardiothoracic Surgery: Cutting Edge SESSION TYPE: Original Investigations PRESENTED ON: 10/11/2023 07:15 am - 08:15 am PURPOSE: Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR) in the past few decades. Multiple studies have been done to define the rate of structural valve deterioration (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. METHODS: This retrospective observational cohort single-center study was conducted between 2014 and 2019 among patients who underwent Trifecta SAVR. Data were collected from electronic medical records, including clinical characteristics, operative intervention, and echocardiographic data at baseline and follow-up (3-5 years). The primary outcome was to assess the rate of structural valve deterioration (SVD) in patients following Trifecta valve implantation, clinically or by evaluating echocardiographic characteristics. Statistical analysis was performed with a significance level of p ≤ 0.05. RESULTS: A total of 270 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.7 years. The mean baseline preoperative ejection fraction (EF) was 53.7%, with no change (p=0.88) in the immediate postoperative EF (53.8%). A most recent follow-up EF revealed a significant increase of EF (55.2%), p=0.01. Also, there was a significant increase from peak velocity (PV)IPE to PVMRE (Mean difference ± SME [0.15 ± 0.04], p<0.01), an increase in Pressure Gradient (PG)IPE to PGMRE (MD ± SME [1.73 ± 0.50], p=0.01), and a decrease in DVIIPE to DVIMRE (MD± SME [-0.037 ± 0.01], p=0.01). Regarding the SVF rate, 15 (5.6%) patients had failed valves requiring replacement throughout the study period. CONCLUSIONS: Over a 5-year follow-up period, 5.9% had a structural valve failure, which is lower compared to other studies, suggesting that valve implantation in experienced surgical centers could be an important factor in reducing valve complications and failure. CLINICAL IMPLICATIONS: Over the 5-year follow-up period, SVF was 5.9% and SVD was 17%, which is lower compared to other studies. The majority of SVD were not clinically significant except in 4 patients. Experienced surgical centers could be an important factor in reducing valve complications and failure. DISCLOSURES: No disclosure on file for Faiz Abbas No disclosure on file for Tamer Altamimi No relevant relationships by Rupinder Buttar No disclosure on file for Mohammed Eisa No relevant relationships by Ahmed Elkhapery No relevant relationships by Anas Hashem No relevant relationships by Amani Khalouf No disclosure on file for Mohamad Mohamad No disclosure on file for Seif Rehman No disclosure on file for Hamza Waheed