{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:37:00Z","timestamp":1793795820461,"version":"4.6.1"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Several concerns have been recently raised regarding the durability of Trifecta prostheses. Different mechanisms of early failure were reported. Our aim was to study in a large population the modes of failure of Trifecta valves.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We conducted a retrospective analysis of patients who underwent surgical aortic valve replacement with a Trifecta prosthesis during the period 2010\u20132018. Details regarding the mode of failure and haemodynamic dysfunction were collected for patients who underwent reintervention for structural valve failure. The Kaplan\u2013Meier method was used to calculate survival. Competing risk analysis was performed to calculate the cumulative risk of reintervention for structural valve failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The overall population comprises 1228 patients (1084 TF model and 144 TFGT model). Forty-four patients\u2014mean patients\u2019 age at the time of the first implant 69 (standard deviation: 12) years and 61% female\u2014underwent reintervention for structural valve failure after a median time of 63 [44\u201374] months. The cumulative incidence of reintervention for structural valve failure was 0.16% (SE 0.11%), 1.77% (SE 0.38%) and 5.11% (SE 0.98%) at 1, 5 and 9 years, respectively. In 24\/44 patients (55%), a leaflet tear with dehiscence at the commissure level was found intraoperatively or described by imaging assessment. The cumulative incidence of reintervention for failure due to leaflet(s) tear was 0.16% (SE 0.11%), 1.08% (SE 0.29%) and 3.03% (SE 0.88%) at 1, 5 and 9 years, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Leaflet(s) tear with dehiscence along the stent post was the main mode of early failure, up to 5\u2009years, after Trifecta valves\u2019 implantation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivac086","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T12:12:24Z","timestamp":1648037544000},"source":"Crossref","is-referenced-by-count":9,"title":["Modes of failure of Trifecta aortic valve prosthesis"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-2670","authenticated-orcid":false,"given":"Pietro Giorgio","family":"Malvindi","sequence":"first","affiliation":[{"name":"Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Kattach","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suvitesh","family":"Luthra","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK"},{"name":"University of Southampton , Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7407-3358","authenticated-orcid":false,"given":"Sunil","family":"Ohri","sequence":"additional","affiliation":[{"name":"Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK"},{"name":"University of Southampton , Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"2022072010380243700_ivac086-B1","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.jtcvs.2018.11.020","article-title":"Trifecta has lower gradient and less prosthesis-patient mismatch than Mosaic Ultra in the aortic position: a prospective randomized study","volume":"158","author":"Braathen","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022072010380243700_ivac086-B2","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.athoracsur.2020.07.040","article-title":"Durability and performance of 2298 trifecta aortic valve prostheses: a propensity-matched analysis","volume":"111","author":"Yongue","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B3","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.athoracsur.2016.09.073","article-title":"Midterm durability and hemodynamic performance of a third-generation bovine pericardial prosthetic aortic valve: the Leipzig experience","volume":"103","author":"Lehmann","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jtcvs.2016.07.080","article-title":"Mid-term durability of the Trifecta bioprosthesis for aortic valve replacement","volume":"153","author":"Anselmi","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022072010380243700_ivac086-B5","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1016\/j.athoracsur.2020.11.026","article-title":"Premature structural failure of Trifecta bioprosthesis in midterm follow-up: a single-centre study","volume":"112","author":"Kattach","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B6","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.athoracsur.2019.12.071","article-title":"Trifecta versus perimount magna ease aortic valve prostheses","volume":"110","author":"Biancari","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B7","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.athoracsur.2019.06.032","article-title":"Early structural valve degeneration of Trifecta bioprosthesis","volume":"109","author":"Fukuhara","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B8","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.athoracsur.2019.05.073","article-title":"Early first-generation Trifecta valve failure: a case series and a review of the literature","volume":"109","author":"Kaneyuki","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B9","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.athoracsur.2018.12.036","article-title":"Excessive pannus overgrowth on the aortic side of Trifecta valve causing severe regurgitation","volume":"108","author":"Schaefer","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2022072010380243700_ivac086-B10","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.jtcvs.2017.05.044","article-title":"Early Trifecta valve failure: report of a cluster of cases from a tertiary care referral center","volume":"154","author":"Kalra","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022072010380243700_ivac086-B11","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1093\/ejcts\/ezx244","article-title":"Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the 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