title: Prophylactic reoperation after mitral valve replacement with the Starr-Edwards ball valve: a report of four cases.
abstract: OBJECTIVE
  The Starr-Edwards ball valve was first applied clinically in 1960. In our hospital, this valve has been used since 1963, and some patients have been followed up for 30 years or more. Based on our experience, therapeutic strategies included revalve replacement as a preventive procedure in the absence of valve-related complications. In this study, we investigated whether prophylactic reoperation after valve replacement with the Starr-Edwards ball valve is appropriate.
  
  
  METHODS
  Of 58 patients in our institute who underwent mitral valve replacement with the Starr-Edwards ball valve, 12 underwent revalve replacement. Of these 12, the subjects of the present study were 4 patients who underwent prophylactic revalve replacement.
  
  
  RESULTS
  The mean postoperative follow-up of the 4 patients was 31.0+/-3.7 years. There were no operative deaths or postoperative complications. On examination of the extirpated Starr-Edwards valves, cloth wear was observed in all 4 patients. Although there was no influence on the range of ball motion, they showed the entity of "thrombus/pannus."
  
  
  CONCLUSIONS
  In this study, all of the patients showed cloth wear in the absence of complications. Therefore we consider that prophylactic reoperation after valve replacement with the Starr-Edwards valve should be performed to prevent complications.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Niino
authors.forename: Masataka
authors.initials: M
authors.lastname: Yoda
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Umeda
authors.forename: Kazuma
authors.initials: K
authors.lastname: Shimura
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Furukawa
authors.forename: Kohtaroh
authors.initials: K
authors.lastname: Tokai
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation