Suture technique does not affect hemodynamic performance of the small supra-annular Trifecta bioprosthesis.
Publication/Presentation Date
10-1-2014
Abstract
OBJECTIVE: The study objective was to evaluate whether aortic valve replacement with the Trifecta valve (St Jude Medical Inc, St Paul, Minn) using simple sutures produces better hemodynamic performance than valve replacement with noneverting pledget-reinforced sutures.
METHODS: We analyzed prospectively acquired 1-year hemodynamic data of patients with small aortic annulus sizes who were enrolled in a multicenter trial of the Trifecta aortic valve bioprosthesis and underwent aortic valve replacement with a 19-mm or 21-mm bioprosthesis between August 2007 and November 2009. We compared preoperative clinical information and 1-year postoperative hemodynamic data for noneverting pledget-reinforced sutures (group 1) versus everting mattress sutures or simple sutures (group 2).
RESULTS: A total of 346 patients underwent aortic valve replacement: 269 in group 1 and 77 in group 2. Preoperative demographic characteristics for the 2 groups were similar. For groups 1 and 2, the mean gradient was 10.4±4.7 mm Hg and 11.1±4.4 mm Hg for 19-mm valves, respectively, and 8.4±3.5 mm Hg and 8.8±3.6 mm Hg for 21-mm valves, respectively; the effective orifice area was 1.40 cm2 and 1.25 cm2 for 19-mm valves, respectively, and 1.57 cm2 and 1.50 cm2 for 21-mm valves, respectively. The rate of severe prosthesis-patient mismatch (indexed effective orifice area≤0.65 cm2/m2) was 18.6% (n=11) and 25% (n=6) for 19-mm valves, respectively, and 10.9% (n=20) and 16.3% (n=8) for 21-mm valves, respectively.
CONCLUSIONS: The suture method did not affect hemodynamic performance of supra-annular bioprostheses in patients with small aortic annulus sizes. Choice of suture technique should be determined by surgeon experience and local anatomic features.
Volume
148
Issue
4
First Page
1347
Last Page
1351
ISSN
1097-685X
Published In/Presented At
Ugur, M., Byrne, J. G., Bavaria, J. E., Cheung, A., Petracek, M., Groh, M. A., Suri, R. M., Borger, M. A., & Schaff, H. V. (2014). Suture technique does not affect hemodynamic performance of the small supra-annular Trifecta bioprosthesis. The Journal of thoracic and cardiovascular surgery, 148(4), 1347–1351. https://doi.org/10.1016/j.jtcvs.2013.12.006
Disciplines
Medicine and Health Sciences
PubMedID
24518226
Department(s)
Department of Surgery
Document Type
Article