BACKGROUND: Between 1963 and 1977 a total of 415 patients admitted to the University Hospital Munich underwent an isolated valve replacement with a Starr-Edwards prosthesis in the aortic or mitral position. METHODS: A retrospective follow-up of 87.1% of the patients representing 4,254 patient-years was completed. Surviving patients were examined by means of echocardiography. RESULTS: Survival rates after 10, 20, and 30 years were 62.3%, 39.4%, and 19.9% after aortic valve replacement and 75%, 36.5%, and 22.6% after mitral valve replacement (operative mortality excluded). Freedom from all valve-related complications, reoperations, and valve-related death was 66.4%, 43.3%, and 23.8% after aortic valve replacement and 73.4%, 35.4%, and 14.3% after mitral valve replacement. Of the surviving patients, 82% and 76% who received aortic or mitral valves, respectively, are in New York Heart Association class I or II. The pressure gradients of the aortic valves were between 20 and 73 mm Hg; those of the mitral valves were between 9 and 30 mm Hg. Fifty-two percent of aortic and 68% of mitral valves show no echocardiographic peculiarities. The left ventricular function in both groups is normal in 64%. CONCLUSIONS: The long-term results together with the echocardiographic results show that after 30 years the Starr-Edwards valve represents a standard that still needs to be achieved by newer prostheses.
BACKGROUND: Between 1963 and 1977 a total of 415 patients admitted to the University Hospital Munich underwent an isolated valve replacement with a Starr-Edwards prosthesis in the aortic or mitral position. METHODS: A retrospective follow-up of 87.1% of the patients representing 4,254 patient-years was completed. Surviving patients were examined by means of echocardiography. RESULTS: Survival rates after 10, 20, and 30 years were 62.3%, 39.4%, and 19.9% after aortic valve replacement and 75%, 36.5%, and 22.6% after mitral valve replacement (operative mortality excluded). Freedom from all valve-related complications, reoperations, and valve-related death was 66.4%, 43.3%, and 23.8% after aortic valve replacement and 73.4%, 35.4%, and 14.3% after mitral valve replacement. Of the surviving patients, 82% and 76% who received aortic or mitral valves, respectively, are in New York Heart Association class I or II. The pressure gradients of the aortic valves were between 20 and 73 mm Hg; those of the mitral valves were between 9 and 30 mm Hg. Fifty-two percent of aortic and 68% of mitral valves show no echocardiographic peculiarities. The left ventricular function in both groups is normal in 64%. CONCLUSIONS: The long-term results together with the echocardiographic results show that after 30 years the Starr-Edwards valve represents a standard that still needs to be achieved by newer prostheses.
Authors: Thierry Le Tourneau; Vanessa Lim; Jocelyn Inamo; Fletcher A Miller; Douglas W Mahoney; Hartzell V Schaff; Maurice Enriquez-Sarano Journal: Chest Date: 2009-05-29 Impact factor: 9.410