title: Structural valve deterioration in a starr-edwards mitral caged-disk valve prosthesis.
abstract: BACKGROUND
  The durability of the Starr-Edwards (SE) mitral caged-disk valve, model 6520, is not clearly known, and structural valve deterioration in the SE disk valve is very rare.
  
  
  RESULTS
  Replacement of the SE mitral disk valve was performed in 7 patients 23-40 years after implantation. Macroscopic examination of the removed disk valves showed no structural abnormalities in 3 patients, in whom the disk valves were removed at <26 years after implantation. Localized disk wear was found at the sites where the disk abutted the struts of the cage, in disk valves excised >36 years after implantation in 4 patients. Disk fracture, a longitudinal split in the disk along its circumference at the site of incorporation of the titanium ring, was detected in the valves removed 36 and 40 years after implantation, respectively, and many cracks were also observed on the outflow aspect of the disk removed 40 years after implantation.
  
  
  CONCLUSIONS
  Disk fracture and localized disk wear were found in the SE mitral disk valves implanted >36 years previously. The present results suggest that SE mitral caged-disk valves implanted >20 years previously should be carefully followed up, and that those implanted >30 years previously should be electively replaced with modern prosthetic valves
authors.affiliation: Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Fukutsu, Japan. shigeakiaoyagi@gmail.com
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Aoyagi
authors.forename: Kei-Ichiro
authors.initials: K
authors.lastname: Tayama
authors.forename: Teiji
authors.initials: T
authors.lastname: Okazaki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shintani
authors.forename: Michitaka
authors.initials: M
authors.lastname: Kono
authors.forename: Kumiko
authors.initials: K
authors.lastname: Wada
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Kosuga
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Mori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011475:Prosthesis Failure; D013997:Time Factors