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Le Bars F, Tomasi J, Belhaj Soulami R, Colas F, Anselmi A, Verhoye JP. Long-term follow-up of the Shelhigh™ superstentless bioprosthesis aortic valve and valved conduit in a monocentric experience. THE JOURNAL OF CARDIOVASCULAR SURGERY 2020; 61:776-783. [PMID: 32558524 DOI: 10.23736/s0021-9509.20.11219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Shelhigh™ SuperStentless (Shelhigh, INC., Union, NJ, USA) is a stentless aortic valve bioprosthesis and aortic root valved conduit. In 2007, this device was recalled by FDA due to malfunction, and subsequently reintegrated by BioIntegral Surgical™ Few data are available over late durability of this device. We performed a long-term follow-up of Shelhigh™ devices implanted at our center. METHODS Between 2002 and 2007, 44 patients underwent aortic valve replacement with a Shelhigh™ device (40 aortic valve bioprosthesis and 4 valved conduit). We performed a clinical and echocardiographic follow-up (9.2 years±4.3). Standardized definitions of valve-related events were adopted. RESULTS At discharge, maximum and mean aortic gradients averaged 36.1±11.3 and 21.0±6.8 mmHg, respectively. The 30-days mortality was 2.3%. Over the follow-up period, 29 patients died (65.9%); 2 deaths were valve related. Overall survival at 1, 5 and 10 years was 97.7%, 85.8% and 54% respectively. At last echocardiography, average transvalvular gradients had remained globally stable in the population (33.6±12 and 20.4±10.5 mmHg). Eight (19%) structural valve deterioration (SVD) events were reported. Two (5%) non-structural valve dysfunction (NSVD) events occurred (periprosthetic leak). Two (5%) infectious endocarditis events and two (5%) valve thromboses were also deplored. Three (7%) patients required re-operation (2 due to SVD and 1 due to endocarditis). CONCLUSIONS The immediate hemodynamic performance of the Shelhigh™ aortic bioprostheses was unexpectedly suboptimal. Despite this, hemodynamic performance remained stable over time. Patients survival at follow-up was satisfactory, however, continued surveillance is necessary.
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Affiliation(s)
- Florent Le Bars
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France
| | - Jacques Tomasi
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France
| | - Reda Belhaj Soulami
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France
| | - Fabrice Colas
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France
| | - Amedeo Anselmi
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France -
| | - Jean-Philippe Verhoye
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital Center, Rennes, France
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Mariscalco G, Mariani S, Bichi S, Biondi A, Blasio A, Borsani P, Corti F, De Chiara B, Gherli R, Leva C, Russo CF, Tasca G, Vanelli P, Alfieri O, Antona C, Di Credico G, Esposito G, Gamba A, Martinelli L, Menicanti L, Paolini G, Beghi C. St. Jude Medical Trifecta aortic valve: results from a prospective regional multicentre registry. J Cardiothorac Surg 2015; 10:169. [PMID: 26589286 PMCID: PMC4654896 DOI: 10.1186/s13019-015-0379-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/12/2015] [Indexed: 12/04/2022] Open
Abstract
Background The Trifecta aortic bioprosthesis (St. Jude Medical, Inc., St. Paul, MN, USA) is a stented pericardial heart valve with excellent preliminary results. Aim of the study was to evaluate its early clinical and hemodynamic performances in a multicenter regional registry. Methods Between January 2011 and June 2012, 178 consecutive patients undergoing aortic valve replacement with the Trifecta bioprosthesis were prospectively enrolled at 9 Italian centers. Clinical and echocardiographic data were collectedat discharge, 6-months and at 1-year postoperatively. Results The average age was 75.4 ± 7.7 years,and 95 (53 %) were men. Indication for valve replacement included stenosis in 123 patients (69 %), mixed lesions in 25 (14 %), and regurgitation in 30 (17 %). Ninety-three (52 %) patients were in NYHA functional class III/ IV. Hospital mortality accounted for 5 (2.8 %) patients. No valve-related perioperative complications were encountered. Median follow-up was 20.5 months (range: 1-34). Early (≤6 months) complications included one thromboembolic event, one major bleeding, and 3 endocarditis (2 explants). Two late (>6 months) thromboembolic events and two endocarditis (1 explant) were registered. No valve thrombosis or structural deterioration were observed after discharge. At 30-months, freedom from all-cause mortality was 87 %, freedom from valve-related mortality 99.4 %, freedom from endocarditis 97.5 %, and freedom from valve explants 98 %. At 1-year, mean gradients ranged from 8 to 16 mmHg, and effective orifice area indexes from 1.0 to 1.2 cm2/m2 for valve sizes from 19 to27 mm, respectively. No patients had severe prosthesis-patient mismatch. Conclusions Trifecta bioprosthesis provided favourable clinical and hemodynamic results over time.
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Affiliation(s)
- Giovanni Mariscalco
- Department of Cardiovascular sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
| | - Silvia Mariani
- Cardiac Surgery Clinic, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Samuele Bichi
- Section of Cardiac Surgery, Department of Cardiovascular Disease, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Andrea Biondi
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
| | - Andrea Blasio
- Department of Cardio-Thoracic and Vascular Surgery, Università Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Borsani
- Department of Cardiovascular sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Fabrizio Corti
- Cardiac Surgery Clinic, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Benedetta De Chiara
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Cà Granda Hospital, Milan, Italy
| | - Riccardo Gherli
- Department of Cardiovascular sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
| | - Cristian Leva
- Department of Cardiac Surgery, Ospedale Civile di Legnano, Legnano, Italy
| | - Claudio Francesco Russo
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Cà Granda Hospital, Milan, Italy
| | - Giordano Tasca
- Cardiac Surgery Unit, Alessandro Manzoni Hospital of Lecco, Lecco, Italy
| | - Paolo Vanelli
- Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy
| | - Ottavio Alfieri
- Department of Cardio-Thoracic and Vascular Surgery, Università Vita-Salute San Raffaele, Milan, Italy
| | - Carlo Antona
- Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy
| | - Germano Di Credico
- Department of Cardiac Surgery, Ospedale Civile di Legnano, Legnano, Italy
| | - Giampiero Esposito
- Section of Cardiac Surgery, Department of Cardiovascular Disease, Cliniche Humanitas Gavazzeni, Bergamo, Italy
| | - Amando Gamba
- Cardiac Surgery Unit, Alessandro Manzoni Hospital of Lecco, Lecco, Italy
| | - Luigi Martinelli
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular Department, Niguarda Cà Granda Hospital, Milan, Italy
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
| | - Giovanni Paolini
- Cardiac Surgery Clinic, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Cesare Beghi
- Department of Cardiovascular sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester, United Kingdom
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