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Archives of cardiovascular diseases
Volume 106, n° 4
page 250 (avril 2013)
Doi : 10.1016/j.acvd.2013.03.016

Hemodynamic profile changes during exercise of the new St-Jude trifecta aortic bioprosthesis: Results from a French multicentre exercise echocardiographic study

F. Levy a, E. Donal b, L. Biere c, C. Szymanski a, J.-P. Remadi a, E. Flecher b, O. Fouquet c, A. Leguerrier b, C. Tribouilloy a
a CHU d’Amiens, Amiens, France 
b CHU de Rennes, Rennes, France 
c CHU d’Angers, Angers, France 

Objectives .– Initial experience with the new supra-annular pericardial stented St-Jude Trifecta aortic bioprosthesis reports excellent resting hemodynamic profiles. Nevertheless, little is know concerning haemodynamic profile changes of aortic bioprostheses during exercise.

Methods .– Between February 2011 and September 2012, 57 patients (26 men; mean age 75±9) with severe symptomatic aortic stenosis who underwent AVR with the new St-Jude Trifecta Bioprosthesis were prospectively included in a French multicentre study (University hospitals of Amiens, Rennes and Angers). All patients who were able to exercise underwent quantitative Doppler echocardiographic measurements at rest and during semi supine exercise test at 6months after AVR. Doppler parameters were recorded at rest, at low level (25W) and at peak exercise (53±8W).

Results .– None of the patients had significant paravalvular leakage. For all valve size, the mean peak transvalvular aortic velocity, mean transvalvular gradient (TVG) and the left ventricular ejection fraction, were respectively:

– 210±35cm/s; 11±3mmHg and 60±11% at rest;

– 235±52cm/s; 13±4mmHg and 63±11% at low level of exercise;

– 248±70cm/s; 15±5mmHg and 67±10% at peak exercise.

At rest, Effective orifice area was 1.89±0.44cm2, went up to 1.78±0.60cm2 at low level exercise and up to 1.95±0.62cm2 at peak exercise. Mean TVG increase was 22±29% from rest to low level and by 46±38% from rest to peak exercise.

Conclusions .– The new St-Jude stented bioprosthesis Trifecta provides excellent hemodynamic performances both at rest and during exercise.

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