Early hemodynamic performance of the Trifecta™ surgical bioprosthesis aortic valve in Indian patient population: 12 month outcomes of the EVEREST ... View Full Text


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Article Info

DATE

2018-12

AUTHORS

Gopichand Mannam, Yugal Mishra, Rajan Modi, Alla Gopala Krishna Gokhale, Rajan Sethuratnam, Kaushal Pandey, Rajneesh Malhotra, Sumit Anand, Anushreeta Borah, Sushan Mukhopadhyay, Dhiren Shah, Tek Singh Mahant

ABSTRACT

BACKGROUND: Indian patients undergoing surgical aortic valve replacement (SAVR) differ from western populations with respect to aortic annulus size and valve disease morphology. The purpose of this post-market, non-randomized observational study was to evaluate the early hemodynamic performance of the Trifecta™ bioprosthesis (Abbott, previously St. Jude Medical, Minneapolis, US) in an Indian patient population. METHODS: From January 2014 to September 2015, 100 patients (mean age 64.4 ± 7.1 years, 62% male) undergoing SAVR for valve disease (68% stenosis, 7% insufficiency, 25% mixed pathology) were enrolled across 10 centers in India. Patients implanted with a 19-27 mm Trifecta™ valve were eligible to participate and were prospectively followed for 12-months post-implantation. Echocardiographic hemodynamic performance was evaluated at pre-implant, pre-discharge and at 12-months by an independent core laboratory. Adverse events were adjudicated by the study sponsor. Functional status at 12-months was assessed according to NYHA classification. Continuous data was summarized using descriptive statistics (mean &standard deviation,) and categorical data was summarized using frequencies and percentages. RESULT: Ninety patients (mean age 64.5, 62.2% male) completed the 12-month follow up. Significant improvements in hemodynamic valve performance were reported in 81 patients with available echocardiographic data at 12 months. Compared to baseline at 12-month follow up visit, mean effective orifice area increased from 0.75cm2 to 1.61cm2 (p < 0.0001), mean pressure gradient reduced to 10.42 mmHg from 51.47 mmHg (p < 0.0001), cardiac output increased from 4.46 l/min to 4.85 l/min (P 0.9254). Compared to baseline, functional status improved by ≥1 NYHA class in 75% of patients at 12 months (95% Clopper-Pearson (Exact) confidence limit [64.6%, 83.6%]). No instances of early mortality (< 30 days from index procedure) or structural valve dysfunction were reported. CONCLUSION: In an Indian patient population, implantation of the Trifecta™ bioprosthesis is shown to be safe and associated with favorable early hemodynamic performance and improved functional status at 12 months. TRIAL REGISTRATION: The clinical study has been registered under Clinical Trial Registry-India ( http://www.ctri.nic.in ) and registration number is CTRI/2014/02/004434 registered on 25 February 2014 retrospectively registered. More... »

PAGES

96

References to SciGraph publications

  • 2014-07. Early outcomes and hemodynamics after implantation of the Trifecta aortic bioprosthesis in GENERAL THORACIC AND CARDIOVASCULAR SURGERY
  • 2008-03. Tissue heart valve implantation in India; Indications, results and impact on quality of life in INDIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
  • 2007-06. Aortic valve replacement in predominant aortic stenosis: What is an appropriate size valve? in INDIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s13019-018-0783-9

    DOI

    http://dx.doi.org/10.1186/s13019-018-0783-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1107223477

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30253784


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