St. Jude Trifecta tissue valve

[SB42]

It appears many select mechanical vs. tissue (esp at younger ages). For my own personal reasons, I chose bovine tissue valve. The choice of product that my Surgeon, John Garrett, uses is the St. Jude Trifecta valve (my model number is the TF-21A). I will keep you updated on progress.

http://sjmprofessional.com/Products/Intl/Heart-Valve-Replacement/Trifecta-Valve.aspx

Best,

SB42

 

[Jkm7]

Best wishes, SB.
Please do keep us updated.

I have Carpentier Edwards bovine valve and know for me it was the right choice. We each have to make that choice and not look back.

Best wishes.

 

[tobagotwo]

I have the St. Jude BioCore, which is a "mixed grille" tissue valve with porcine leaflets and bovine pericardium at the commissures.

Do be aware that the Trifecta has an MRI limitation, which is unusual for tissue valves. It uses a titanium stent, rather than a flexible plastic stent:

MRI Safety Information

Non-clinical testing has demonstrated that the Trifecta Valve is MR conditional. It can be scanned safely under the following conditions:
• Static magnetic field of 3 Tesla or less
• Spatial gradient of 525 Gauss/cm or less
• Maximum whole-body-averaged specific absorption rate (SAR) of 2.0-W/kg for 15 minutes of scanning.
In non-clinical testing, the Trifecta Valve produced a temperature rise of less than or equal to 0.5°C at a maximum whole body averaged specific absorption rate (SAR) of 2.0 W/kg for 15 minutes of MR scanning in a 3-Tesla Signa model (GE) MR scanner. MR image quality may be compromised if the area of interest is the exact same area or relatively close to the position of the bioprosthesis.

However, the purpose of the nonflexible stent is to allow the leaflets to be attached on the outside of the stent, allowing a greater, effective opening. The unit can't be used if it's dropped, due to concern that the stent could deform and the valve work improperly. I don't know what the profile is for the stent in a concussive injury after it's in place.

Best wishes,

 

[SB42]

I appreciate the information Bob H and will do my due diligence. But as we all know, anytime we put a foreign object in our body, mechancial or tissue, there are always going to be pros & cons. I will focus on the pros and educate myself on the cons.

Respectfully,

SB42

 

[tobagotwo]

Not intended to change your mind about anything at all: it's just something to be aware of.

ALL heart valves have shortcomings, issues, Things To Be Aware Of. It's just best when we know about them beforehand, so we aren't surprised later.

Best wishes,

 

[SB42]

no offense taken, Bob...I appreciate your candid response...this is how we learn...and trust me, it will be a topic of conversation that I will have with my surgeon...information is power...thank you again, sir!

 

[mn2mx]

I came through my surgery well, am home and getting about back in the woods. I just got a card in the mail which said I have a TF-21 heart valve from St Jude, also. I kinda remember a surgeon in the ICU saying the other surgeon was hoping to get at least a 23mm valve in, but the opening was too small. Anyone know anything about this? I'm alive, that's all I care about now.

 

[Fundy]

mn2mx, what are you asking about, the surgeon comment about hoping for a 23mm but the opening only big enough for a 21mm to fit correctly?

Basically to get a 23mm to fit a 21mm opening they would have had to surgically enlarge the opening, which they sometimes do to prevent valve mismatch for a person's body size. However, it makes that surgery a bit more risky and any subsequent ones even riskier. I've read patient stories where the guy expected a tissue valve but because the opening was too small the surgeon had to enlarge the opening for a valve of a suitable size and because of the higher risk at a future resurgery time, the surgeon opted for a mechanical instead.

I imagine the surgeon was hoping for at least a 23mm as that may be a suitable cutoff point for present valve-in-valve usage at this time perhaps. The bigger the valve the bigger the TAVR that will fit.

http://www.annalscts.com/article/view/928/1096
This article suggests that the present Sapien XT of 23mm would be riskier to put within a 21mm Trifecta, mentioning in the tabled section:
"*The suggested Sapien™ size will create high trans-valvular gradients. This option should be used only in inoperable patients"

The article closes with a conclusion:
" In conclusion, the 23 mm Sapien™ XT seems to be the most useful TAVI valve because it fits within the majority of currently used bioprostheses (23 mm and the 25 mm diameter). We suggest implanting large bioprosthesis during first-time standard AVR in order to prevent size mismatch in case of future VinV procedures."


My guess is that he was hoping to use a valve of a suitable size for what's out there now for a possible future TAVR. However I think they are using smaller than 23mm TAVR's now in studies anyway. It might be something you would want to bring up with a cardiologist or surgeon. Maybe asking what the smallest possible TAVR within your valve would be doable which would not be a mismatch for your body size.

 

[mn2mx]

Thanks Fundy...I suspected it was something like that. Well...in 15 years I'll be 82 and I hope things will have progressed by then. For now, I'm just recuperating. Too late to turn back.