Objectives .– Initial experience with the new supra-annular pericardial stented St-Jude Trifecta aortic bioprosthesis reports excellent resting hemodynamic profiles. Nevertheless, little is know concerning haemodynamic profile changes of aortic bioprostheses during exercise.

Methods .– Between February 2011 and September 2012, 57 patients (26 men; mean age 75 ± 9) with severe symptomatic aortic stenosis who underwent AVR with the new St-Jude Trifecta Bioprosthesis were prospectively included in a French multicentre study (University hospitals of Amiens, Rennes and Angers). All patients who were able to exercise underwent quantitative Doppler echocardiographic measurements at rest and during semi supine exercise test at 6 months after AVR. Doppler parameters were recorded at rest, at low level (25 W) and at peak exercise (53 ± 8 W).

Results .– None of the patients had significant paravalvular leakage. For all valve size, the mean peak transvalvular aortic velocity, mean transvalvular gradient (TVG) and the left ventricular ejection fraction, were respectively:

– 210 ± 35 cm/s; 11 ± 3 mmHg and 60 ± 11% at rest;

– 235 ± 52 cm/s; 13 ± 4 mmHg and 63 ± 11% at low level of exercise;

– 248 ± 70 cm/s; 15 ± 5 mmHg and 67 ± 10% at peak exercise.

At rest, Effective orifice area was 1.89 ± 0.44 cm ² , went up to 1.78 ± 0.60 cm ² at low level exercise and up to 1.95 ± 0.62 cm ² at peak exercise. Mean TVG increase was 22 ± 29% from rest to low level and by 46 ± 38% from rest to peak exercise.

Conclusions .– The new St-Jude stented bioprosthesis Trifecta provides excellent hemodynamic performances both at rest and during exercise.