Thorac Cardiovasc Surg 2019; 67(04): 266-273
DOI: 10.1055/s-0038-1637011
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Randomized (CO)mparison of (TRI)fecta and (P)erimount Magna Ease Supraannular Aortic Xenografts—CO.TRI.P Study

Arnaud Van Linden
1  Department of Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany
2  Department of Cardiac Surgery, University Hospital Frankfurt, Germany
,
Mani Arsalan
1  Department of Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany
2  Department of Cardiac Surgery, University Hospital Frankfurt, Germany
,
Thore Körschgen
3  Department of Cardiology, Kerckhoff Klinik, Bad Nauheim, Germany
,
Johannes Blumenstein
4  Department of Cardiology, St. Johannes Hospital, Dortmund, Germany
,
Jörg Kempfert
5  Department of Cardiac Surgery, German Heart Center, Berlin, Germany
,
Florian Hecker
1  Department of Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany
2  Department of Cardiac Surgery, University Hospital Frankfurt, Germany
,
Thomas Walther
1  Department of Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany
2  Department of Cardiac Surgery, University Hospital Frankfurt, Germany
› Author Affiliations
Funding Before starting this study, the protocol was given to both manufacturers. The study was then supported by an unrestricted grant from St. Jude Medical, Eschborn, Germany.
Further Information

Publication History

31 October 2017

30 January 2018

Publication Date:
01 May 2018 (online)

Abstract

Background Modern supraannular aortic xenografts offer a special design, thus providing maximized opening area for improved hemodynamics. The aim of this study was a prospectively randomized comparison of the Trifecta and the Perimount Magna Ease valves based on metric annulus sizing.

Methods A total of 100 patients with aortic stenosis undergoing aortic valve replacement (AVR) with or without concomitant procedures were prospectively included. After decalcification of the annulus, stratified intraoperative randomization was performed. The diameter of the aortic annulus was measured using metric Hegar dilators and randomization was based on this metric annulus diameter. Exercise echocardiography was performed at 10-month follow-up.

Results Mean age was 69 years, with 36% female. Predominant implanted valve sizes were 23 mm (39%) and 25 mm (32%). Unadjusted mean pressure gradient was significantly lower and effective orifice area larger for the Trifecta group (10.8 ± 5 vs. 13.2 ± 4 mm Hg, p = 0.02 and 1.93 ± 0.39 vs. 1.70 ± 0.30 cm2, p = 0.002) at discharge. In patients with small annuli, based on the metric annulus size there were no significant differences in gradients or the orifice area. At exercise echocardiography follow-up, there were no significant hemodynamic differences between both prostheses.

Conclusions The Trifecta and the Perimount Magna Ease prostheses both show excellent hemodynamic performance after AVR. In patients with larger annuli, the Trifecta valve seems to be even superior to the Magna Ease, which may be advantageous in obese patients.

Supplementary Material