AI Article Synopsis
- The study aimed to compare the haemodynamics of three types of bioprostheses in patients who underwent aortic valve replacement (AVR) for aortic stenosis.
- 60 patients were randomly assigned to receive either Freestyle, Magna Ease, or Trifecta bioprostheses and underwent echocardiography six months post-surgery.
- Results showed that the Trifecta bioprosthesis had significantly better resting and exercise haemodynamics compared to Magna Ease, but no significant differences were found between Trifecta and Freestyle.
Article Abstract
Objectives: The purpose of this study was to compare haemodynamics at rest and during exercise after clinically indicated aortic valve replacement (AVR) for aortic stenosis among patients randomly assigned to one of three haemodynamically excellent bioprostheses.
Methods: In a single-centre, prospective trial, 60 patients undergoing clinically indicated AVR were randomly assigned to Freestyle, Magna Ease or Trifecta bioprostheses. Six months after surgery, patients underwent supine bicycle stress echocardiography for the assessment of aortic valve haemodynamics.
Results: There were 5 protocol deviations from random valve assignments, and 4 patients did not return for follow-up stress echo, yielding a study group of 56 patients {17 Freestyle, 21 Magna Ease, 18 Trifecta; median age 70 [interquartile range (IQR) 63-78 years], 37 (66%) men}. There were no statistically significant differences between groups in valve size, concomitant procedures or exercise variables. Resting haemodynamics revealed significant differences between groups in mean gradient [Freestyle 7 (IQR 5-9) mmHg, Magna Ease 9 (IQR 7-11) mmHg, Trifecta 5 (IQR 4-8) mmHg; P = 0.04], effective orifice area (EOA) [2.5 (IQR 2.2-2.7), 2.1 (IQR 1.7-2.3) and 2.6 (IQR 2.3-2.8), respectively; P = 0.02] and EOA index [1.22 (IQR 1.11-1.32), 1.02 (IQR 0.89-1.14) and 1.31 (IQR 1.00-1.42), respectively; P = 0.03]; in each case, Trifecta had better haemodynamics compared with Magna Ease. With exercise, significant differences between groups were evident in peak velocity at 50 watts and peak exercise; mean gradient at 25 watts, 50 watts and maximal exercise; and EOA at 25 watts and at peak exercise; all with haemodynamic superiority of Trifecta compared with Magna Ease. There were no statistically significant differences between Trifecta and Freestyle haemodynamics at rest or with exercise.
Conclusions: In a prospective, randomized study comparing haemodynamics after Freestyle, Magna Ease and Trifecta, all three valves exhibited good haemodynamics at rest and with exercise. There were small but significant differences between groups, with favourable haemodynamics associated with Trifecta compared to Magna Ease, and no significant differences between Trifecta and Freestyle. The Trifecta valve appears to offer haemodynamics similar to a stentless valve without the technical complexity of stentless valve implantation.
Clinicaltrialsgov Identifier: NCT01635244.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ejcts/ezv493 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Sutureless and Rapid Deployment Prosthesis in Redo-Bentall Endocarditis.
Case Rep Surg
October 2024
Department of Cardiac Surgery, "Vito Fazzi" Hospital, Lecce, Italy.
Aortic valve replacement (AVR) in a patient with a bio-Bentall conduit can be very challenging, especially if there was a previous endocarditis process for significant morbidity and mortality. We report a case of sutureless AVR in an old patient with a bio-Bentall conduit (Carpentier-Edwards Perimount Magna Ease 25 aortic valve and Hemashield 30 aortic conduit), who developed an endocarditis on aortic prosthesis valve. We believe that sutureless AVR is the best option for redo-operation in older patients with a high surgical risk because it allows for easy rapid deployment implantation, avoids anchoring sutures on a fragile aortic anulus, and reduces cardiopulmonary and aortic cross-clamp times.
View Article and Find Full Text PDFAdaptation of Aortic Bioprosthetic Valves for Pulmonary Position: Comparative Analysis of Transcatheter and Surgical Valves.
J Cardiovasc Transl Res
December 2024
Department of Mechanical and Materials Engineering, University of Denver, 2155 E. Wesley Ave, Room 439, Denver, CO, 80208, USA.
Article Synopsis
- Pulmonary valve dysfunction is frequent in congenital heart disease, often requiring procedures like right ventricular outflow tract reconstruction, with transcatheter pulmonary valve replacement (TPVR) now being a successful alternative to traditional surgery.
- This study compares two bioprosthetic valves: the Carpentier Edwards Perimount Magna Ease surgical valve and the Edwards SAPIEN 3 transcatheter valve, noting that the latter was originally designed for aortic use but has been adapted for pulmonary applications.
- Significant differences were observed in the hydrodynamic and structural characteristics of the valves under pulmonary and aortic conditions, enhancing the understanding of the biomechanics involved in both surgical and transcatheter replacements.
Comparison of four aortic bioprostheses: Hancock II St Jude Trifecta Carpentier-Edwards Perimount Magna Magna Ease-mid-term results (COMPARE SAVR study).
J Thorac Dis
August 2024
CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
Background: In the era of percutaneous aortic valve implantation, biological valves are the preferred prostheses implanted in patients undergoing surgical aortic valve replacement (sAVR). The aim was to present a real-life analysis of mid-term sAVR outcomes for the four aortic bioprostheses: the Hancock II, the Carpentier-Edwards Perimount Magna, the Carpentier-Edwards Perimount Magna Ease and the Trifecta valve.
Methods: This is a retrospective study based on data from the Polish National Cardiac Surgery Database.
Multicenter, propensity-weighted comparison of stented, rapid-deployment and new-generation aortic valves.
Int J Cardiol Heart Vasc
October 2024
Division of Cardiac Surgery, University of Padova, Padova, Italy.
Article Synopsis
- The study compares early clinical and hemodynamic outcomes of three types of bioprosthetic valves used in surgical aortic valve replacement: Magna Ease, Intuity, and Inspiris Resilia.
- Data from 2589 patients revealed that the Intuity valve had the shortest aortic cross clamp time, while Inspiris showed the lowest permanent pace-maker implantation rates.
- All devices demonstrated excellent outcomes, but Inspiris had the best overall performance with lower gradient measurements compared to the Magna Ease valve.
The Mitris RESILIA Valve: New Skin for a Proven Design.
Surg Technol Int
July 2024
European Hospital, UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
Article Synopsis
- The mitris valve combines features of two existing valves—the Carpentier-Edwards PERIMOUNT Magna Mitral Ease valve and INSPIRIS RESILIA tissue—for enhanced hemodynamic performance and durability.
- Its design includes a more flexible, saddle-shaped sewing cuff that fits the mitral valve better, reducing risks of complications during double-valve replacements.
- The valve also benefits from advanced technology that minimizes free aldehyde levels, suggesting improved long-term durability and reliability compared to earlier models.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!