Thirty-Year Results of Starr-Edwards Prostheses in the Aortic and Mitral Position

Gödje, O.; Fischlein, T; Adelhard, K.; Nollert, Georg; Klinner, W; Reichart, Bruno

doi:10.1016/s0003-4975(96)00945-9

Cited by 67 publications

(49 citation statements)

References 15 publications

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“…Prosthesis type as a TE predictor is controversial. 4,7,12,34,42,43 These uncertainties stem mostly from differences in TE definition between centers, 5 and uniform TE definition may be an advantage of single-center studies. Recent prostheses are considered less thrombogenic than first-generation prostheses.…”

Section: Effect Of Prosthesis Typementioning

confidence: 99%

Achieved Anticoagulation vs Prosthesis Selection for Mitral Mechanical Valve Replacement

Tourneau

Lim

Inamo

et al. 2009

Chest

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Background: Thromboembolic events (TEs) are frequent after mechanical mitral valve replacement (MVR), but their association to anticoagulation quality is unclear and has never been studied in a population-based setting with patients who have a complete anticoagulation record. Conclusion: This population-based comprehensive study of anticoagulation and TE post-MVR shows that, in these closely anticoagulated patients, anticoagulation intensity was highly variable and not associated with TE incidence post-MVR. Higher anticoagulation intensity is linked to higher variability and, thus, to bleeding. The MVR-ball prosthesis design is associated with higher TE rates notwithstanding higher anticoagulation intensity, and its use should be retired worldwide.(CHEST 2009; 136:1503-1513)

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Section: Effect Of Prosthesis Typementioning

confidence: 99%

Achieved Anticoagulation vs Prosthesis Selection for Mitral Mechanical Valve Replacement

Tourneau

Lim

Inamo

et al. 2009

Chest

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“…These rates of each valve type were almost similar to the previous reports. 4,18 Valve dysfunction because of cloth wear and pannus overgrowth was more extensive than expected based on the reoperations. Clinical manifestations of heart failure, such as increasing dyspnea during exercise, edema of the extremities, disappeared after reoperation, especially in patients who underwent valve replacement more than 20 years ago.…”

Section: Discussionmentioning

confidence: 88%

“…1,2,4 The cloth-covered model of the S-E stellite-ball valve was introduced to eliminate the larger metal surface and ball variance in the original silastic ball prosthesis, with the intention of reducing thromboembolism. The fabric extension was extended from the inflow orifice to the cage (model 2300 and model 6300), and composite seat prosthesis (model 2310 and model 6310), which featured small metallic studs around the orifice was introduced, resulting in the protection of the orifice cloth on valve closure.…”

Section: Discussionmentioning

confidence: 99%

Valve Dysfunction of the Cloth-Covered Starr-Edwards Ball Valve

Shiono

Sezai

Hata

et al. 2005

Circ J

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ince the first successful valve replacement using the original Starr-Edwards (S-E) caged silastic ball valve, some engineering modifications were made to enhance hemodynamic performance and fixation. The fabric covering was extended to the inflow orifice and then to the cage, and a silastic ball was changed to a stellite ball, which resulted in a group of "cloth-covered S-E ball valves". 1,2 Between June 1968 and March 1977, the clothcovered ball valves were used for aortic and mitral valve replacement (MVR) on a routine basis. Long-term results with the S-E ball valves have been reported showing satisfactory results with reliable durability and safety; they could represent the standard in mechanical valve replacement until recent prostheses can show a significant improvement in long-term results. However, reoperation after valve replacement with the S-E ball valve is unavoidable, and there have been only a few articles reporting detailed data concerning reoperations for the cloth-covered model of the S-E ball valve. The present study reports valve dysfunction and reoperation for the cloth-covered S-E ball prostheses. Methods PatientsThe cloth-covered S-E ball valves (aortic model 2300, 2310, 2320, and 2400, and mitral model 6300, 6310, 6320, and 6400) were implanted in the aortic and/or mitral position as the first choice for prosthetic substitution at our institution between June 1968 and March 1977. Oral anticoagulation regimens were administered after surgery and left at our outpatient clinic or local general practitioner's clinic. Among the 66 operative survivors who underwent an isolated aortic valve replacement (AVR; n=14) or MVR (n=52), 20 patients (11 male and 9 female) required reoperation 22 times because of valve dysfunction, thromboembolic complication, paravalvular leakage, hemolytic anemia, and/or prosthetic valve endocarditis. Reoperation was carried out at a mean of 15.9±9.8 years (range, 2.3 to 34.2 years) after initial valve replacement. The S-E valves were re-implanted 8 times in the aortic position (n=7; group A) and 14 times in the mitral position (n=13; group M) at a mean age of 44.7±13.9 years (range, 14 to 66 years). The S-E valves used at the initial operations and indications for reoperation are listed in Table 1. At reoperation, the heart was completely mobilized through a repeat median sternotomy and cardiopulmonary bypass was implemented through the femoral artery or the aorta for arterial perfusion, and right atrium for venous drainage. The patient's systemic temperature was cooled to 32°C and the heart was arrested using St Thomas' cold crystalloid cardioplegic solution. Care was taken during the prosthesis excision not to remove any structures from the prosthetic surfaces to avoid artificial changes on the prosthesis. The prosthetic valve was replaced using an interrupted method with braided polyester sutures or pledgeted polyester sutures at the supra-annular position.Excised valves were carefully examined, and morbidity after the initial and subsequent operations was defined

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“…Otra consideración importante que se desprende de este estudio es que, siendo la severidad de los síntomas y el deterioro de la función ventricular factores que elevan la mortalidad operatoria y disminuyen la supervivencia alejada, debiéramos indicar el reemplazo valvular más precozmente, como lo establecen las actuales guías de la ACC/ AHA 33 y lo reportan autores recientes 15,34 . En cuanto a la prótesis usada, estudios multicéntricos y prospectivos no han mostrado diferencias significativas entre los diferentes tipos de prótesis con respecto a mejoría sintomática, incidencia de complicaciones y supervivencia alejada 2,27,35,36 . Nosotros decidimos utilizar una prótesis mecánica en vez de biológica, dada la edad y la alta incidencia de fibrilación auricular de nuestra serie.…”

Section: Discussionunclassified

Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral

et al. 2013

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Thirty-Year Results of Starr-Edwards Prostheses in the Aortic and Mitral Position

Cited by 67 publications

References 15 publications

Achieved Anticoagulation vs Prosthesis Selection for Mitral Mechanical Valve Replacement

Achieved Anticoagulation vs Prosthesis Selection for Mitral Mechanical Valve Replacement

Valve Dysfunction of the Cloth-Covered Starr-Edwards Ball Valve

Influencia del sistema de salud de procedencia y otros factores en el resultado del reemplazo valvular mitral

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