Valve dysfunction of the cloth-covered Starr-Edwards ball valve.
BACKGROUND
Between June 1968 and March 1977, Starr-Edwards cloth-covered ball valves were used for valve replacement on a routine basis.


RESULTS
Among the 66 operative survivors who underwent an isolated aortic or mitral valve replacement, 20 patients required reoperation 22 times because of valve dysfunction, thromboembolic complication, paravalvular leakage, hemolytic anemia, and/or prosthetic valve endocarditis. Reoperation was performed at a mean of 15.9+/-9.8 years after initial replacement. Excised valves were examined and reoperation after initial operation was reviewed. Operative mortality was 10.0%. Freedom from reoperation for aortic valve replacement and mitral valve replacement was 56.2% at 34 years and 61.0% at 37 years after initial operation, respectively. Cloth wear or pannus formation were observed in all excised prostheses. Orifice cloth was more markedly worn in mitral valves than in aortic valves, particularly in mitral valves of more than 20 years old. Pannus overgrowth contributed to valve regurgitation in the older valves.


CONCLUSIONS
Early diagnosis of valve dysfunction and reoperation are recommended as soon as symptoms appear.
Shiono
Motomi
M
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan. mshiono@med.nihon-u.ac.jp
Sezai
Akira
A
Hata
Mitsumasa
M
Iida
Mitsuru
M
Negishi
Nanao
N
Sezai
Yukiyasu
Y
D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000628:therapy; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation