Wear of the metallic studs on the composite seat of the 2320 Starr-Edwards aortic valve and its clinical consequences.

The 2320 Starr-Edwards aortic valve has a composite seat with metallic studs that protrude through the cloth. Certain clinical and morphologic findings are described in 6 patients who had this prosthesis in situ for 50 to 144 months (mean 92). Considerable disruption of the cloth covering both struts and base, and varying degrees of wear of the metallic studs that line the luminal side of the prosthetic ring occurred in each. Excessive stud wear resulted in severe disruption of the cloth lining the interior of the prosthetic ring. Cloth disruption may be associated with hemolytic anemia, embolic consequences, or both. Of our 6 patients, 4 had severe hemolytic anemia, 4 had neurologic events compatible with emboli and 1 died suddenly. Stud wear as observed in the 2320 series Starr-Edwards prosthesis also may occur in the models 2310 and 2400 prostheses, which have the same composite seat.