Over the years, I have heard from many patients who wanted to learn about the Trifecta heart valve replacement and its clinical trials.  As you might recall, this aortic valve replacement device is described by St. Jude Medical, its manufacturer, as a “next generation” heart valve replacement that:

• Contains three pericardial tissue leaflets;
• Uses a titanium stent covered with polyester and pericardial tissue; and
• Leverages St. Jude’s patented Linx AC Technology to help prevent aortic valve calcification after implant.

Trifecta Heart Valve Replacement (St. Jude Medical)

Recently, there was big news for the Trifecta heart valve replacement when St. Jude announced that this device received FDA approval.

The corporate excitement for the FDA approval was more than apparent when I checked into the Marriott hotel the night before the 91st Annual American Association for Thoracic Surgeons meeting began in Philadelphia. To my surprise… When I looked down at my room key, this is what I saw:

My Trifecta Hotel Room Key During AATS At The Marriott

I’m a little slow at times. I don’t always know when product marketing is happening to me or those around me. But, in that moment, I started to think that the marketing organization at St. Jude Medical was going to use the AATS convention as a launching pad for the Trifecta heart valve replacement. I guess that’s a very appropriate strategy — considering 1,500+ cardiac surgeons attend the AATS meeting each year.

Interestingly, the next morning…

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While the Da Vinci robot is primarily used for mitral valve repair procedures, a handful of clinical cases have leveraged robotic technology for aortic valve replacement.

To get an update on robotic aortic valve replacement, I recently interviewed Dr. Husam Balkhy, the director of minimally invasive and robotic surgery at The Wisconsin Heart Hospital. As you may recall, Dr. Balkhy has performed aortic valve replacement using the Da Vinci robot and the ATS 3f Bioprosthetic valve, a horse valve replacement.

To help those in our patient and caregiver community that are hearing impaired, I have included a transcript of this video interview with Dr. Balkhy below.

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I just received an interesting email from Judy about adhesions, the pericardium and heart valve re-operations.

Judy writes, “Hi Adam, I am a 66-year old female preparing for aortic valve replacement. I have calcification at the sinotubular junction. Reoperation would be tricky in my case as I have an anomalous circumflex artery. I wondered what can be done to minimize the chances of adhesions? Could not closing the pericardium contribute to adhesions? What are the pros and cons of leaving the pericardium open? Thanks, Judy”

Post-Operative Adhesion

To answer Judy’s questions, I contacted Dr. Craig Smith, the chairman of surgery at NewYork-Presbyterian Hospital / Columbia University Medical Center. If you did not know, Dr. Smith recently performed aortic valve replacement on Barbara Walters. Doctor Smith has also operated on Former President Bill Clinton and several members of our patient community including Gary Poltorak.

Dr. Craig Smith – Heart Surgeon of Former President Bill Clinton
and Barbara Walters (NewYork-Presbyterian Hospital)

In his response to Judy, Dr. Smith noted…

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A common consideration among patients preparing for valvular treatment is whether or not they will get a heart valve repair or a heart valve replacement.

Recently, Dr. Lars Svensson and I discussed the clinical indicators for aortic valve repair due to aortic regurgitation. Relative to the mitral valve, here is an educational video in which Dr. Jeffrey Swanson answers Barbara’s question, “From a surgeon’s perspective, what differentiates the need for mitral valve repair versus mitral valve replacement due to mitral regurgitation?”

For those of you interested in learning more about Dr. Jeffrey Swanson, please click here. Also, for the hearing impaired, I have provided a video transcript below.

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Carole recently sent me an interesting email about Ian, her sixteen-year old son who suffers from aortic valve disease.

She writes, “Hi Adam, My son needs to have his aortic valve replaced. His surgery is scheduled for August. We are struggling with the decision of which valve replacement to have implanted. Ian is leaning towards the On-X mechanical valve but is hesitant because of the Coumadin factor. Do you know any other patients in Ian’s age group? What do you think is the best valve replacement for Ian? Thanks so much for your wonderful and informative heart valve book. Carole”

This is a great and complex question. As we have discussed before, if a valve repair is not possible, a key consideration for the patient will be, “Which type of heart valve replacement is best for me?” The answer to that question is dependent upon several factors – including age, active lifestyle, risk factors, etc.

I wanted to provide Carole an expert opinion. So, I contacted Dr. Lucas Collazo.

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