A Propensity Matched Analysis of Outcomes and Age Sex Matched Population Survival Benefit Between TRIFECTA versus All Bioprosthetic Isolated Aortic Valve Replacement

Amer Harky ¹, Mohamad Bashir ¹, Benjamin Adams ¹, Matthew Shaw ², Giridhara Goli ¹, John Yap ¹, Kulvinder Lall ¹

¹ Barts Heart Centre, St Bartholomews Hospital, London, United Kingdom; ² Liverpool heart and chest hospital, Liverpool, United Kingdom;

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – D

Abstract

Objectives:

We aimed to comparatively evaluate the cumulative quality outcomes between all isolated Bioprosthetic aortic valve replacement (AVR) and our population cohort underwent isolated AVR using Trifecta stented valve

Methods:

A retrospective review of a single institution prospectively recorded isolated aortic valve surgery between October 2010 and June 2017 undertaken. Propensity score matching was used to achieve equivalence between pre-operative patient demographics and co-morbidities. Groupwise comparisons of outcomes were made.

Results:

141 isolated Trifecta AVR implants and 879 other biological aortic valve procedures were identified. After 6:1 propensity score matching, there were 127 patients in the Trifecta group and 762 in the comparison group, with no statistically significant differences in their perioperative characteristics. There were no significant differences in the in-hospital mortality (0.8% Trifecta vs. 2.0% other; p=0.71), stroke (3.2% Trifecta vs 1.1% other; p=0.08), reoperation (6.3% Trifecta vs 4.6% other; p=0.41), post-op dialysis (0% Trifecta vs 2.1% other; p=0.15) or post-op length of stay (both medians = 6 days; p=0.20). Groupwise survival data was also analysed, including matching the study cohort by age and sex to the general population, using ONS life tables. The log-rank p-value comparing Trifecta with other biological valves was 0.77, visual inspection of the confidence intervals showed no difference between the study patients and the age and sex matched general population.

Conclusion:

Although Trifecta and all Bioprosthetic valves used for aortic valve replacement amongst our cohort were associated with low morbidity and mortality, the midterm cumulative survival benefit after 4 years for Trifecta valve was superior to all Bioprosthetic valves. The 5-year survival in the matched cohort amongst Trifecta and all Bioprosthetic valves along with the age and sex matched survival of the UK general population showed no significant deviation.