[Rupture of the teflon cover of valvular prosthesis in aortic position. Severe postoperative complication]

Fourteen patients (18.5%) are presented from a total of 78 patients who received a Starr-Edwards prosthesis Model No. 2320 with a Telfon covering, in an aortic position. In the late post-operative period these patients developed complications which merited a surgical reintervention. Twelve of these were operated on to substitute this prosthesis for a distinct type and model. In the other two the teflon covering on the cage of the prosthesis was dried thoroughly. The most frequent complication which made it necessary to reoperate was hemolysis, which would not cede to intense medical treatment. The hemolysis appeared at an average of 20 months post-operatively. In all of the cases we found a rupture due to erosion of the telfon material. This is undoubtably an etiological factor of the hemolysis. Eleven of the 14 cases (78.5%) survived. Ten of which were possible to follow up on a long term basis. Seven of these (70%) are asymptomatic and the remaining 3 (30%) are evolving with data suggestive of peri-prosthetic aortic insuficiency. A review is made of the evolution of Starr-Edwards prosthesis and the causes of the post-operative hemolysis in valvular surgery.