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Perceval or Trifecta to Prevent Patient–Prosthesis Mismatch

2020; Multidisciplinary Digital Publishing Institute; Volume: 9; Issue: 9 Linguagem: Inglês

10.3390/jcm9092964

2077-0383

Daniel Hernández‐Vaquero, Carlota Vigil-Escalera, Yván R. Persia-Paulino, Carlos Morales, Isaac Pascual, Alberto Domínguez‐Rodríguez, Emiliano A. Rodríguez-Caulo, Manuel Carnero, Rocío Díaz, Pablo Avanzas, César Morı́s, Jacobo Silva,

Cardiac pacing and defibrillation studies

The Trifecta aortic valve has excellent hemodynamics characteristics. Moreover, the Perceval prosthesis may achieve better hemodynamics than the conventional valves; therefore, it has been proposed to reduce the incidence of patient-prosthesis mismatch. Our aim was to compare the prevalence of this complication between both prostheses. All patients who underwent valve replacement with a Perceval or a Trifecta from 2016 to 2020 at our institution were included. We calculated the prevalence of patient-prosthesis mismatch for each prosthesis and size and performed a multinomial logistic regression model to investigate the impact of choosing one prosthesis over the other. A total of 516 patients were analyzed. Moderate mismatch was present in 33 (8.6%) in the Trifecta group and 28 (21.4%) in the Perceval group, p < 0.001. Severe mismatch was present in 8 (2.1%) patients with Trifecta and 5 (3.8%) patients with Perceval, p = 0.33. Compared with the Perceval, the Trifecta prosthesis was shown to reduce moderate patient-prosthesis mismatch: OR = 0.5 (95% CI 0.3-0.9, p = 0.02). Both prostheses led to a similar risk of severe patient-prosthesis mismatch: OR = 0.9 (95% CI 0.3-2.8, p = 0.79). Both prostheses provide a very low risk of severe patient-prosthesis mismatch. Compared with the Perceval prothesis, the Trifecta prosthesis is able to reduce by 50% the risk of moderate mismatch.