{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:23:05Z","timestamp":1761110585011},"reference-count":18,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T00:00:00Z","timestamp":1613260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Heart Vessels"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Aortic stenosis (AS) is the most common valve disorder in advanced age. Previous reports have shown that low-flow status of the left ventricle is an independent predictor of cardiovascular mortality after surgery. The Trifecta bioprosthesis has recently shown favorable hemodynamic performance. This study aimed to evaluate the effect of the Trifecta bioprosthesis, which has a large effective orifice area, in patients with low-flow severe AS who have a poor prognosis. We retrospectively evaluated 94 consecutive patients with severe AS who underwent aortic valve replacement (AVR). Patients were divided into two groups according to the stroke volume index (SVI): low-flow (LF) group (SVI\u2009&lt;\u200935\u00a0ml\/m<jats:sup>2<\/jats:sup>, <jats:italic>n<\/jats:italic>\u2009=\u200922) and normal-flow (NF) group (SVI\u2009\u2265\u200935\u00a0ml\/m<jats:sup>2<\/jats:sup>, <jats:italic>n<\/jats:italic>\u2009=\u200972). Patients\u2019 characteristics and early and mid-term results were compared between the two groups. There were no differences in patients\u2019 characteristics, except for systolic blood pressure (LF:NF\u2009=\u2009120:138\u00a0mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and the rate of atrial fibrillation between the groups. A preoperative echocardiogram showed that the pressure gradient was higher in the NF group than in the LF group, but aortic valve area was similar. The Trifecta bioprosthesis size was similar in both groups. The operative outcomes were not different between the groups. Severe patient\u2013prosthesis mismatch (PPM) (&lt;\u20090.65 cm<jats:sup>2<\/jats:sup>\/m<jats:sup>2<\/jats:sup>) was not observed in either of the groups. There were no significant differences in mid-term results between the two groups. The favorable hemodynamic performance of the Trifecta bioprosthesis appears to have the similar outcomes in the LF and NF groups. AVR with the Trifecta bioprosthesis should be considered for avoidance of PPM, particularly in AS patients with LV dysfunction.<\/jats:p>","DOI":"10.1007\/s00380-021-01802-5","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T18:37:00Z","timestamp":1613673420000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of the Trifecta bioprosthetic valve in patients with low-flow severe aortic stenosis"],"prefix":"10.1007","author":[{"given":"Tohru","family":"Takaseya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsunobu","family":"Oryoji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuyoshi","family":"Takagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomofumi","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Arinaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Hiromatsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiki","family":"Tayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,14]]},"reference":[{"key":"1802_CR1","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1093\/ejcts\/ezv449","volume":"49","author":"A Lopez-Marco","year":"2016","unstructured":"Lopez-Marco A, Miller H, Youhana A, Ashraf S, Zaidi A, Bhatti F, Ionescu A, Kumar P (2016) Low-flow low-gradient aortic stenosis: surgical outcomes and mid-term results after isolated aortic valve replacement. 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