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Intraoperative Trifecta Valve Malfunction
Hiroshi Kataoka1, Hiroyuki Tanaka1, Tsutomu Toshida2
1Department of Cardiovascular Surgery, Showa University Fujigaoka Hospital, Kanagawa, Japan.
The Annals of Thoracic Surgery
|January 22, 2021
Summary
Intraoperative dysfunction of the Trifecta valve (aortic valve replacement) can occur, necessitating immediate reoperation. This case highlights potential issues beyond long-term valve performance.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Device Technology
Background:
- The Trifecta bioprosthetic valve is used for aortic valve replacement.
- Previous reports indicate late-stage valve dysfunction (months to years post-operation).
- Intraoperative valve dysfunction has not been previously documented.
Observation:
- A 73-year-old male patient underwent aortic valve replacement with a 21-mm Trifecta valve featuring Glide Technology.
- Severe intraoperative regurgitation occurred immediately after aortic declamping.
- The explanted Trifecta valve showed an unusually outwardly opened mount post.
Findings:
- The patient experienced hemodynamic collapse due to severe intraoperative aortic regurgitation.
- The Trifecta valve was replaced with an alternative bioprosthetic valve.
- The removed valve exhibited a structural anomaly in its mount post.
Implications:
- Intraoperative Trifecta valve dysfunction is a possibility, distinct from late-stage failures.
- Immediate reoperation is crucial for managing acute intraoperative valve dysfunction.
- Careful intraoperative assessment is vital, even without visible valve tears or deformities.
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