Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuoku Kobeshi Hyogoken, Kobe, 650-047, Japan.
J Cardiothorac Surg. 2022 Jul 8;17(1):174. doi: 10.1186/s13019-022-01918-3.
Several studies have reported high rates of structural valve deterioration (SVD) in the Trifecta valves. Herein, we analyzed the midterm results of the Trifecta valve and risk factors for early SVD.
We retrospectively reviewed the records of 110 patients who had undergone Trifecta implantation between January 2012 and December 2017.
We encountered seven cases of Trifecta valve failure. We performed a redo aortic valve replacement in five patients and a transcatheter aortic valve replacement in two patients. The SVD rate was 4.8% at 5 years and 6.6% at 7 years. The mean pressure gradient and peak velocity on the first postoperative echocardiogram in patients with SVD were higher than those in patients without SVD. The SVD rates with and without patient-prosthesis mismatch (PPM) were 2.8% and 12.6% at 5 years and 2.8% and 20.0% at 7 years. PPM is a risk factor for SVD. Noncoronary cusp tears were observed in all patients who had undergone redo surgery.
The most common cause of SVD was noncoronary cusp tear. Patients with PPM are at high risk of developing SVD.
多项研究报告称，Trifecta 瓣膜的结构性瓣膜退化（SVD）发生率较高。在此，我们分析了 Trifecta 瓣膜的中期结果和早期 SVD 的危险因素。
我们回顾性分析了 2012 年 1 月至 2017 年 12 月期间接受 Trifecta 植入术的 110 例患者的记录。
我们发现 7 例 Trifecta 瓣膜失效。我们对 5 例患者进行了再次主动脉瓣置换术，对 2 例患者进行了经导管主动脉瓣置换术。SVD 发生率在 5 年时为 4.8%，7 年时为 6.6%。SVD 患者术后首次超声心动图的平均压力梯度和峰值速度高于无 SVD 患者。有和无患者-假体不匹配（PPM）的 SVD 发生率在 5 年时分别为 2.8%和 12.6%，在 7 年时分别为 2.8%和 20.0%。PPM 是 SVD 的危险因素。所有接受再次手术的患者均观察到非冠状动脉瓣叶撕裂。
SVD 的最常见原因是非冠状动脉瓣叶撕裂。有 PPM 的患者发生 SVD 的风险较高。
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