5-Year Hemodynamic Performance of Four Different Stented Biological Aortic Valves

Objectives: Stented biological valves are still implanted in large numbers. The manufactures try to let us believe that there are performance differences. But is that true? We looked at 4 different widely implanted biological valves implanted in aortic position.

Methods: Between 2011 and 2019, a total of 1,034 patients (67.1% male, mean: 69.8 years; 32.9% female, mean: 72.2 years) were enrolled receiving Perimount (N = 340), crown (N = 340), trifecta (N = 250), and Perceval (N = 104) with or without concomitant CABG, atrial ablation, left atrial appendage closure, or wrapping of the ascending aorta. Double or triple valve procedures as well as concomitant prosthetic aortic procedures were excluded. All patients received echocardiography prior to discharge and after 1, 3, and 5 years. Statistics were calculated using SPSS.

Result: The early mortality was 1.6% for elective patients and 6.1% overall; incidence of perioperative stroke was 2.9%. The 1-year mortality was 5.8% for elective patients and 11.2% overall. Mean transvalvular gradients (mm Hg) remained stable throughout the entire follow-up period:

Mean gradient (mm Hg)	Prior to discharge	1 year	3 years	5 years
Perimount	13.4	11.0	11.2	11.5
Crown	14.4	13.8	14.6	15.4
Trifecta	9.8	9.6	11.3	14.1
Perceval	15.5	11.6	11.2	14.0

Conclusion: All valves demonstrated reasonable performance up to 5 years. Perceval being a rapid deployment valve did not differ from the three conventional stented valves. Stented biological valves provide good hemodynamic results without showing differences favoring one valve over the other.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
19 February 2021