Hemodynamic performance of 3 difference bioprothesis: SJM Trifecta vs. Sorin Mitroflow and stentless Sorin Solo

Objective: Concern about optimizing hemodynamics in tissue valves has led to innovations in aortic valves design. This study aim to compare the hemodynamic performance of 3 different pericardial bioprosthesis.

Methods: A total of 224 consecutive patients with aortic valve disease underwent aortic valve replacement between 2006 and 2013. Three different bioprotheses were implanted: SJM Trifecta (group TF, n = 82), Sorin Mitroflow (group MF, n = 102), and Sorin Solo stentless bioprothesis (group Solo, n = 40). Clinical and hemodynamic data were prospectively recorded and compared. Hemodynamic performance was evaluated by transthoracic echocardiography at baseline, discharge, and 3-months follow-up.

Results: Preoperative characteristic were similar between groups. There were no perioperative deaths in either group. Cardiopulmonary bypass time was 100 ± 26 min in the TF, 111 ± 35 min in MF (p = n.s.), and 108 ± 20 min in the FS group (p = n.s.). Aortic cross-clamp times were 68 ± 18 min in TF, 75 ± 25 min in MF (p = n.s.), and 73 ± 14 min in the FS group (p = n.s.). The peak and mean transvalvular gradient at discharge were superior in the TF compared to MF group (16.8 ± 6.6 mmHg and 8.6 ± 3.3 mmHg vs. 21.2 ± 8.4 mmHg and 12.1 ± 5.4 mmHg; p = 0.001), but similar to Solo group (15.3 ± 6.1 and 7.9 ± 3.4 mmHg ; p = n.s.). This could be proven at 3 months postoperatively (TF 17.1 ± 6 mmHg and 9.2 ± 3.5 mmHg; MF 21.45 ± 10.69 mmHg and 11.1 ± 6.1 mmHg; p  < 0.01 and Solo 14.8 ± 7.1 mmHg and 7.8 ± 3.8 mmHg). At 3 months follow-up, the NYHA class were significantly superior to pre-op data (mean 2.6 vs. 1.5, respectively) with no differences among groups.

Conclusions: At discharge and 3 months follow-up, hemodynamic performance of the stented TF bioprothesis seems to be superior to the MF prosthesis and comparable to the stentless Solo prosthesis.