Seo Hiroyuki, Tsutsumi Yasushi, Monta Osamu, Numata Satoshi, Yamazaki Sachiko, Yoshida Shohei, Samura Takaaki, Ohashi Hirokazu
Department of Cardiovascular Surgery, Fukui Cardiovascular Center, Shinbo 2-228, Fukui, 910-0833, Japan,
Gen Thorac Cardiovasc Surg. 2014 Jul;62(7):422-7. doi: 10.1007/s11748-013-0362-x. Epub 2013 Dec 17.
The Trifecta valve is a recent, newly designed high performance valve, with few studies on the clinical and hemodynamic data. The purpose of this study was to evaluate the early clinical and echocardiographic results of the Trifecta valve.
Between April 2012 and December 2012, 23 consecutive patients underwent aortic valve replacement with the Trifecta valve in our institution. Clinical and hemodynamic data were prospectively recorded and hemodynamic performance was assessed by transthoracic echocardiography.
Nine patients were male and the overall mean age was 75 ± 9 years. Twenty patients suffered aortic stenosis, and 3 suffered aortic insufficiency. Prosthesis sizes implanted were: 19 mm (n = 4), 21 mm (n = 12), and 23 mm (n = 7). There were no 30-day deaths and no valve-related events during follow-up, except for 1 postoperative stroke. The mean postoperative transprosthetic pressure gradient was 10.0 ± 1.4, 9.6 ± 3.6, and 7.1 ± 3.6 mmHg, and the effective orifice area was 1.45 ± 0.13, 1.68 ± 0.16, and 1.90 ± 0.28 cm(2), for valve sizes 19, 21, and 23 mm, respectively. One patient had moderate prosthesis-patient mismatch. No moderate to severe aortic regurgitation was observed. The mean pressure gradient in aortic stenosis patients decreased significantly from 49.9 ± 20.7 to 8.9 ± 3.6 mmHg (p < 0.001). Left ventricular mass index in all patients decreased significantly from 142.0 ± 33.6 to 115.4 ± 26.4 g/m(2) (p < 0.001).
The Trifecta aortic bioprosthesis provided satisfactory early outcomes and hemodynamic function.
Trifecta瓣膜是一种近期新设计的高性能瓣膜，关于其临床和血流动力学数据的研究较少。本研究的目的是评估Trifecta瓣膜的早期临床和超声心动图结果。
2012年4月至2012年12月期间，我们机构连续23例患者接受了Trifecta瓣膜主动脉瓣置换术。前瞻性记录临床和血流动力学数据，并通过经胸超声心动图评估血流动力学性能。
9例为男性，总体平均年龄为75±9岁。20例患者患有主动脉瓣狭窄，3例患有主动脉瓣关闭不全。植入的人工瓣膜尺寸为：19mm（n = 4），21mm（n = 12）和23mm（n = 7）。除1例术后中风外，无30天死亡病例，随访期间无瓣膜相关事件。对于19mm、21mm和23mm尺寸的瓣膜，术后平均跨瓣压差分别为10.0±1.4、9.6±3.6和7.1±3.6mmHg，有效瓣口面积分别为1.45±0.13、1.68±0.16和1.90±0.28cm²。1例患者存在中度人工瓣膜-患者不匹配。未观察到中度至重度主动脉瓣反流。主动脉瓣狭窄患者的平均压差从49.9±20.7显著降至8.9±3.6mmHg（p < 0.001）。所有患者的左心室质量指数从142.0±33.6显著降至115.4±26.4g/m²（p < 0.001）。
Trifecta主动脉生物瓣膜提供了令人满意的早期结果和血流动力学功能。
