An old friend is still at work: 34-year-old well functioning Starr-Edwards aortic prosthesis without anticoagulation.

The Starr-Edwards caged-ball valve prosthesis is the beginning mark of the valve replacement era, and was used widely in many centers worldwide in the past decades. Despite long term results with this prosthesis have been reported with satisfactory hemodynamic performance, only a few cases have been reported exceeded 30 years of durability. We report the case of a patient with a 34-year-old well-functioning Starr-Edwards ball prosthesis in aortic position using neither antiaggregant nor anticoagulant therapies.