Aortic valve replacement with Starr-Edwards valves over 14 years.
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 patients 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 cage-ball prosthesis 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.
D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation; D012826:Silicone Elastomers; D013923:Thromboembolism / Q000209:etiology / Q000401:mortality
D012826:Silicone Elastomers