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Ann Thorac Surg 1982;33:562-569
© 1982 The Society of Thoracic Surgeons

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Articles

Aortic Valve Replacement with Starr-Edwards Valves over 14 Years

From the Department of Surgery, Cardiothoracic Institute, London, England

Accepted for publication October 8, 1981.

^* Address reprint requests to Mr. Ross, Department of Surgery, Cardiothoracic Institute, 2 Beaumont St, London W1N 2DX, England

Three hundred thirteen patients underwent aortic valve replacement with 319 Starr-Edwards caged-ball prostheses and have been followed for 1 to 14 years. Hospital mortality (24.8%) and first-year mortality (4.8%) suggest that this is a high-risk group. Overall postoperative patient survival was 37.1%, with 18.8% free from any event, at 14 years. Thromboembolism was the most significant single event (a probability of 18.7% at 14 years), and the Series 2300/2320 valves were associated with a probability of hemolysis of nearly 80% over 13 years.

Patients who underwent valve replacement before 1973 had a significantly greater probability of late death (31.1%) and of complications (47.1%) during the first 5 years. Those patients undergoing replacement after 1973 had a significantly greater probability of thromboembolic episodes (15.4%).

Starr-Edwards caged-ball prostheses provide an acceptable valve replacement for high-risk patients. However, the overall complication rate of 81.2% over 14 years, compared with 78% for homograft valves for the same period, does not support the adoption of this prosthesis as the valve of first choice at this hospital.

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