Hemodynamic performance and midterm clinical outcomes after surgical aortic valve replacement using trifecta and perimount magna valves: a Japanese single-center experience

Abstract

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.

Keywords: Aortic valve disease; Surgical aortic valve replacement; Aortic root replacement; Bioprosthetic valve; Structural valve deterioration.