Forty-year survival with the Starr-Edwards heart valve prosthesis.
OBJECTIVE
The study aim was to update an analysis of the long-term survival of heart valve replacement using the Starr-Edwards prosthesis.


METHODS
Cases of isolated aortic (AVR, n = 2,247) and mitral (MVR, n = 1,406) valve replacement with Starr-Edwards prostheses implanted between 1960 and 1997, with follow up to 2003, were reviewed. Introduced in 1965, the Models A1200/1260, M6120 are still in use (Current), while other models have been discontinued (Discontinued). For AVR, 938 valves were Discontinued, with a total follow up of 8,506 patient-years (pt-yr) and a maximum of 41 years; by comparison, 1,309 valves were Current, with a total follow up of 11,586 pt-yr and a maximum of 36.1 MVR, were Discontinued, with a total follow up of 6,454 pt-yr and maximum of 37.2 years; and 771 valves were Current, with a total follow up of 6,211 pt-yr and maximum of 37.0 years.


RESULTS
Kaplan-Meier (KM) survival at 10 years was 53% for AVR and 51% for MVR; KM survival at 20 years was 23% for both AVR and MVR; KM survival at 30 years was 8% for both AVR and MVR; KM survival at 40 years was 4% for AVR. The standard error for all KM percentages was 1%. Four patients are currently alive with their original valves, more than 40 years after implantation.


CONCLUSIONS
This series of patients, who underwent valve replacement with the Starr-Edwards valve, now have a follow up extending beyond 40 years, thereby confirming the excellent durability of this valve.
Gao
Guangqiang
G
Providence Health System, Portland, Oregon, USA.
Wu
YingXing
Y
Grunkemeier
Gary L
GL
Furnary
Anthony P
AP
Starr
Albert
A
D000206:Actuarial Analysis; D001021:Aortic Valve; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D011474:Prosthesis Design; D015996:Survival Rate; D013997:Time Factors