Durabilidad de la bioprótesis Trifecta™ a medio plazo: experiencia de un centro

Abstract

Introduction and backgroundAlthough most studies have shown that the Trifecta™ bioprosthesis (Abbott Vascular, Santa Clara, California) has an excellent hemodynamic performance, there have been an increase of premature structural failure of the Trifecta™ bioprosthesis. The main objective of this study weas to report our single-center experience. MethodsWe performed a retrospective analysis including all patients undergoing aortic valve replacement with Trifecta™ prosthesis from 2013 July to 2021 July in our center. Fine-Gray regression model was created with structural valve degeneration and death as competing risk events. Results453 patients underwent an aortic valve replacement with a Trifecta™ aortic bioprosthesis. Mean age was 71.6±10.1 years, with 55.4% (n=251) men. Median follow-up was 40 (IQR 20-58) months. The incidence of moderate-severe structural valve deterioration was 5.5% (n=25). Overall freedom from moderate-severe structural valve degeneration at 1year, 3years and 5years was 99.7%, 97.5% and 92.7%, respectively. The multivariable analysis age over 80years was detected as an independent protective factor for early structural valve deterioration (sHR 0.21 [0.05-0.86], P=.03). A higher incidence in prosthetic sizes less than or equal to 21mm was not detected (sHR 0.46 [0.21-1.01], P=.054). ConclusionsThe Trifecta™ bioprosthesis presented a rate of early structural deterioration higher than expected. Patients with Trifecta™ prostheses should be closely followed-up with yearly echocardiograms.