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Ann Thorac Surg 1987;43:368-372
© 1987 The Society of Thoracic Surgeons

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Articles

Ten-Year Clinical Evaluation of Isolated Mitral Valve and Double-Valve Replacement with the Starr-Edwards Prostheses

Departments of Cardiothoracic Surgery and Clinical Cardiology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom

Accepted for publication June 12, 1986.

^* Address reprint requests to Dr. Fessatidis, Department of Cardiothoracic Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Rd, London W12 OHS, United Kingdom

From 1974 through 1983, 689 hospital survivors of Starr-Edwards (SE) valve replacement were identified; 279 (40.4%) patients with complete follow-up had an isolated mitral valve (SE model 6120 or 6400) replacement: 60.6% of these patients were women, 33.4% were in sinus rhythm, 32.3% had predominantly mitral stenosis, and 23.6% had predominantly regurgitation. Forty-six (6.7%) patients had mitral and aortic valve (SE model 1260 or 2400) replacement, 60.9% were women, and 13% were in sinus rhythm.

To determine the long-term outcome of these SE valve prostheses, 325 (97.8%) patients were observed for up to 10 years. Total 10-year mortality was 40 patients (2.54% patients/yr) in the mitral group, of which 26 deaths (9.3%) were cardiac in origin; 8 deaths (2.8%) were directly valve related. Eight patients died (3.47% patients/yr) in the double-valve group, of which 5 deaths (10.8%) had a cardiac cause; 2 deaths (4.3%) were directly valve related. Primary valve failure was never proved. Actuarial estimates of survival at 10 years were 82 ± 2.6% for the mitral valve group and 81 ± 6% for the double-valve group. Actuarial estimates of freedom from valve-related morbidity were 87 ± 2% for the mitral valve group and 59 ± 7% for the double-valve group. Actuarial estimates of freedom from thromboembolism were 93 ± 2% for the mitral valve group and 70 ± 7% for the double-valve group.

This prosthesis-based assessment has shown satisfactory long-term performance characteristics of the SE mitral models 6120 and 6400 without any recorded episodes of mechanical valve dysfunctions.

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