Key result
In an in vitro flow chamber, the Trifecta 23 mm bioprosthesis demonstrated lower maximum average velocity compared to the Perimount Magna Ease (0.70 vs 0.81 m/s, P<0.001) under pulsatile flow.
Why the study?
The study was conducted to compare the in vitro flow dynamics of the Perimount Magna Ease and Trifecta bioprostheses.
Does the Trifecta bioprosthesis improve flow dynamics compared to the Perimount Magna Ease in an in vitro model?
Does the Trifecta bioprosthesis improve flow dynamics compared to the Perimount Magna Ease in an in vitro model?
Absolute Event Rate: 0.7% vs 0.81%
p-value: p=< .001
Both Trifecta and Perimount Magna Ease bioprostheses showed good hemodynamic performance in an in vitro flow chamber, with Trifecta demonstrating lower velocities and shear strength but more leaflet flutter.
In vitro PIV data highlight flow differences between PME and TF valves; leaves open clinical hemodynamic impact.
Objectives: We aimed to compare the in vitro flow dynamics of the Perimount Magna Ease™ (PME) and the Trifecta™ (TF) bioprostheses.Material and methods: A new flow chamber was designed to compare the flow patterns of the PME (Edwards Lifesciences, Irvine, CA, USA) and the TF (SJM, St. Paul, MN, USA) aortic valve prostheses. This new channel offered the possibility of 2D-particle-image-velocimetry (2D-PIV) to completely evaluate the flow field downstream from the aortic valve to the middle of the aortic arch. Maximum average velocities, vorticity, shear strength, maximum orifice diameters and jet flow diameters were analyzed. Valve sizes of 21, 23 and 25 mm were evaluated.Results: Average velocity values, shear strength and vorticities were smaller in the flow field of the TF (maximum average velocity: 0.81 ± 0.03m/s, PME 23 mm vs. 0.7 ± 0.02m/s TF 23 mm, P < .001) under pulsatile flow conditions (70 Hz, 70 mL stroke volume). The evaluation of the upper orifice area revealed bigger maximum diameters during the peak flow phase for the TF, but more leaflet-flutter.Conclusions: Our flow chamber allowed a precise and highly sensitive characterization and comparison of complex fluid dynamics of different aortic valve prostheses. Both the Trifecta™ and the Perimount Magna Ease™ showed a good performance on a high level.
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Marx et al. (2019) studied this question. Trifecta (TF) bioprosthesis vs. Perimount Magna Ease (PME) bioprosthesis was evaluated on Maximum average velocity (23 mm valve) (p=< .001). In an in vitro flow chamber, the Trifecta 23 mm bioprosthesis demonstrated lower maximum average velocity compared to the Perimount Magna Ease (0.70 vs 0.81 m/s, P<0.001) under pulsatile flow.
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