Isolated replacement of the mitral valve with the Starr-Edwards prosthesis

Isolated mitral valve replacement with the Starr-Edwards prosthesis has been performed on 657 patients at the Mayo Clinic during the 11 year period ending January, 1972. The most recent subset of that series comprised patients who received the Model 6120 prosthesis. In this group, the operative mortality rate was 9 per cent and the actuarial late death rate at 5 years was 20 per cent. This survival rate is a significant improvement over the natural history of severe mitral valve disease. Factors associated with operative deaths are large left artrial size, advanced functional class, and previous heart surgery. Variables associated with higher incidence of late deaths are large left atrial size, patient age at operation, and multivalve disease. Risk of thromboembolism is increased with large left atrial size, presence of left atrial thrombus, and inadequate anticoagulant therapy.