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6 Year Follow-up of Aortic Valve Reoperation Rates: Carpentier-Edwards Perimount vs St. Jude Medical Trifecta
  • +3
  • Herman Stubeda,
  • Hashem Aliter,
  • Ryan Gainer,
  • Chris Theriault,
  • Steve Doucette,
  • Gregory Hirsch
Herman Stubeda
Dalhousie University Faculty of Medicine
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Hashem Aliter
Dalhousie University Faculty of Medicine
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Ryan Gainer
Dalhousie University Faculty of Medicine
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Chris Theriault
Nova Scotia Health Authority
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Steve Doucette
Nova Scotia Health Authority
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Gregory Hirsch
Dalhousie University Faculty of Medicine
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Peer review status:UNDER REVIEW

18 Jun 2020Submitted to Journal of Cardiac Surgery
18 Jun 2020Submission Checks Completed
18 Jun 2020Assigned to Editor
23 Jun 2020Reviewer(s) Assigned
02 Jul 2020Review(s) Completed, Editorial Evaluation Pending
06 Jul 2020Editorial Decision: Revise Major
25 Jul 20201st Revision Received
30 Jul 2020Submission Checks Completed
30 Jul 2020Assigned to Editor
01 Aug 2020Reviewer(s) Assigned


Background The Carpentier-Edwards Perimount valves have a proven track record in aortic valve replacement: good durability, hemodynamic performance, rates of survival, and infrequent valve-related complications and PPM. The St. Jude Medical Trifecta is a newer valve that has shown comparable early and midterm outcomes. Studies show reoperation rates of Trifecta are comparable to Perimount valves, with a few recent studies bringing into focus early SVD, and increased midterm SVD in younger patients. Given that midterm data for Trifecta is still sparse, we wanted to confirm the early low reoperation rates of Trifecta persist over time compared to Perimount. Methods The Maritime Heart Centre Database was searched for isolated AVR or AVR+CABG between January 2011 and December 2016. Primary end point of the study was all-cause reoperation rate. Results 711 Perimount and 453 Trifecta implantations were included. The reoperation hazards were determined for age: 0.96 (0.92-0.99, p=0.02), female (vs male): 0.35 (0.08-1.53, p=0.16), smoker (vs non-smoker): 2.44 (0.85-7.02, p=0.1), and Trifecta (vs Perimount): 2.68 (0.97-7.39, p=0.06). Kaplan-Meier survival analysis in subgroups—age < 60, age ≥ 60, male, female, smoker, and non-smoker—showed Perimount having lower reoperation rates than Trifecta in patient younger than 60 (p=0.02) and those with smoking history (p<0.01). Conclusions The rates of reoperation of Perimount and Trifecta were comparable, with Trifecta showing higher rates in patients younger than 60 years, and current smokers. Continued diligence and further independent reporting of midterm reoperation and SVD rates of the Trifecta, including detailed echocardiographic follow up, are needed to confirm these findings.