Early Experience with the Latest-Generation Biological Prosthesis, the Trifecta™ GT.

BACKGROUND: The study aim was to assess the hemodynamic results and implantation technique for the latest-generation St. Jude Medical aortic valve bioprosthesis, the Trifecta™ GT, which was first marketed in 2016.

METHODS: The first 100 patients (mean age 74.59 ± 7.41 years) undergoing aortic valve replacement (AVR) with the Trifecta GT, whether associated or not with other procedures, were included and assessed. All patients underwent a baseline ultrasound scan prior to hospital discharge to monitor postoperative gradients and the presence of periprosthetic leakage.

RESULTS: The predominant valvular heart disease was aortic stenosis (85%). An isolated AVR was required in 43% of patients. The prosthesis sizes used were 19, 21, 23, 25, and 27 mm. The overall hospital mortality was 5%; all deaths occurred in patients with associated surgeries. Peak gradients measured prior to hospital discharge ranged from 17.95 mmHg to 10.95 mmHg for 19 mm and 27 mm prostheses, respectively; mean gradients were 9.94 and 6.18 mmHg for 19 mm and 27 mm prostheses, respectively. Neither implant-related complications nor significant periprosthetic leakages were recorded.

CONCLUSIONS: Based on experience with patients, the Trifecta GT demonstrated an excellent hemodynamic performance after implantation, which involved a simple and safe technique. Further long-term studies to determine the durability of the prosthesis are required.