使用Trifecta和Perimount Magna瓣膜进行主动脉瓣置换术后的血流动力学性能和中期临床结果：日本单中心经验
Hemodynamic performance and midterm clinical outcomes after surgical aortic valve replacement using trifecta and perimount magna valves: a Japanese single-center experience.
作者信息
Miura Yujiro, Ichihara Nao, Kawaguchi Shinji, Nomura Ryota, Nakai Masanao, Yamazaki Fumio, Onodera Tomoya, Kitaoka Hiroaki
机构信息
Division of Cardiovascular Surgery, Department of Surgery, Kochi University, Kochi Medical School, 185-1, Kohasu, Okomachi, Nangoku-City, Kochi, 780-8505, Japan.
Department of Cardiovascular Surgery, The Jikei University School of Medicine, Tokyo, Japan.
出版信息
J Cardiothorac Surg. 2025 Aug 8;20(1):326. doi: 10.1186/s13019-025-03565-w.
BACKGROUND
Surgical bovine pericardial bioprosthetic valves have become popular because of their improved durability; however, with the rise of transcatheter aortic valve implantation, bioprosthetic valves that offer superior hemodynamics are needed. This single-center observational study aimed to compare the hemodynamic performance of the Trifecta and Magna valve bioprostheses.
METHODS
Patients with aortic stenosis, aortic regurgitation, or aortic annulus ectasia who underwent surgical aortic valve replacement, aortic valve-preserving surgery, or the modified Bentall procedure at the Shizuoka City Shizuoka Hospital between 2013 and 2019 were recruited. Patients who received Trifecta (Trifecta group) and Magna valves (Magna group) were retrospectively analyzed. All-cause mortality rates and major adverse cardiac and cerebrovascular events were the primary and secondary outcomes, respectively.
RESULTS
A total of 500 patients were included; 131 and 369 patients in the Trifecta and Magna groups, respectively. Both groups had a low in-hospital mortality rate (1.5%). Survival rates at 5 and 8 years were similar, with lower rates in the Trifecta group (p = 0.346). Both groups had similar major adverse cardiac and cerebrovascular event rates up to 2.7 years post-surgery, but the Trifecta group showed higher rates than did the Magna group thereafter. Over a mean period of 3.16 years, seven Trifecta patients were diagnosed with structural valve deterioration, while no patients from the Magna group were affected.
CONCLUSION
While the Trifecta valve may offer better hemodynamics than those by the Magna valve, it may not necessarily improve the midterm prognosis of patients undergoing surgical aortic valve replacement or modified Bentall procedures.
TRIAL REGISTRATION
This study was retrospectively registered in IRB approval no., 21-85 on 21st. September. 2021.
背景
外科用牛心包生物瓣因其耐久性提高而受到欢迎；然而，随着经导管主动脉瓣植入术的兴起，需要具有更优血流动力学性能的生物瓣。这项单中心观察性研究旨在比较Trifecta和Magna瓣膜生物瓣的血流动力学性能。
方法
招募2013年至2019年期间在静冈市静冈医院接受主动脉瓣置换术、保留主动脉瓣手术或改良Bentall手术的主动脉狭窄、主动脉反流或主动脉瓣环扩张患者。对接受Trifecta瓣膜（Trifecta组）和Magna瓣膜（Magna组）的患者进行回顾性分析。全因死亡率和主要不良心脑血管事件分别作为主要和次要结局。
结果
共纳入500例患者；Trifecta组和Magna组分别有131例和369例患者。两组的院内死亡率均较低（1.5%）。5年和8年生存率相似，Trifecta组的生存率较低（p = 0.346）。两组术后2.7年内的主要不良心脑血管事件发生率相似，但此后Trifecta组的发生率高于Magna组。在平均3.16年的时间里，7例Trifecta瓣膜患者被诊断为瓣膜结构退化，而Magna组无患者受影响。
结论
虽然Trifecta瓣膜可能比Magna瓣膜具有更好的血流动力学性能，但它不一定能改善接受主动脉瓣置换术或改良Bentall手术患者的中期预后。
试验注册
本研究于2021年9月21日在IRB批准号21 - 85中进行回顾性注册。
Zotero 插件