Three-year hemodynamic performance, left ventricular mass regression, and prosthetic-patient mismatch after rapid deployment aortic valve replacement in 287 patients

Objective Superior aortic valve hemodynamic performance can accelerate left ventricular mass regression and enhance survival and functional status after surgical aortic valve replacement. This can be achieved by rapid deployment aortic valve replacement using a subannular balloon-expandable stent fr...

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Published in:The Journal of thoracic and cardiovascular surgery 2014-12, Vol.148 (6), p.2854-2861
Main Authors: Haverich, Axel, MD, Wahlers, Thorsten C., MD, PhD, Borger, Michael A., MD, PhD, Shrestha, Malakh, MBBS, PhD, Kocher, Alfred A., MD, Walther, Thomas, MD, PhD, Roth, Matthias, MD, Misfeld, Martin, MD, Mohr, Friedrich W., MD, PhD, Kempfert, Joerg, MD, Dohmen, Pascal M., MD, PhD, Schmitz, Christoph, MD, Rahmanian, Parwis, MD, Wiedemann, Dominik, MD, Duhay, Francis G., MD, Laufer, Günther, MD
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Language:eng
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Summary:Objective Superior aortic valve hemodynamic performance can accelerate left ventricular mass regression and enhance survival and functional status after surgical aortic valve replacement. This can be achieved by rapid deployment aortic valve replacement using a subannular balloon-expandable stent frame, which functionally widens and reshapes the left ventricular outflow tract, to ensure a larger effective orifice area compared with conventional surgical valves. We report the intermediate-term follow-up data from a large series of patients enrolled in the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial. Methods In a prospective, multicenter (6 European hospitals), single-arm study, 287 patients with aortic stenosis underwent rapid deployment aortic valve replacement using a stented trileaflet bovine pericardial bioprosthesis. Core laboratory echocardiography was performed at baseline, discharge, and 3 months, 1 year, and 3 years after rapid deployment aortic valve replacement. Results The mean patient age was 75.7 ± 6.7 years (range, 45-93; 49.1% women). The mean aortic valve gradient significantly decreased from discharge to 3 years of follow-up. The mean effective orifice area remained stable from discharge to 3 years. At 1 year, the left ventricular mass index had decreased by 14% ( P  
ISSN:0022-5223
1097-685X