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Malfunctioning Starr-Edwards mitral valve 21 years after installation
K Sakata1, S Ishikawa, A Ohtaki
1Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan.
The Journal of Cardiovascular Surgery
|February 1, 1997
Summary
Two Starr-Edwards mitral valve prostheses malfunctioned after 21 years due to tissue ingrowth and valve seat tears. Successful reoperation demonstrates long-term viability of these older mechanical heart valves.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Cardiac Valve Prosthetics
Background:
- Starr-Edwards mechanical heart valves have a long history of clinical use.
- Long-term durability and potential failure modes of older prostheses require ongoing investigation.
- Mitral valve replacement is a common cardiac surgical procedure.
Observation:
- Two patients presented with malfunctioning Starr-Edwards cloth-covered mitral valve prostheses.
- Both prostheses had been implanted for 21 years prior to reoperation.
- Failure mechanisms included poppet obstruction from tissue ingrowth and paravalvular leak due to valve seat tear.
Findings:
- Successful reoperation was performed on both patients after 21 years of prosthesis function.
- Excessive tissue ingrowth interfered with poppet movement, causing malfunction.
- A tear in the valve seat led to a paravalvular leak in the second case.
Implications:
- This report highlights the potential for Starr-Edwards mitral valve prostheses to function for over two decades.
- Reoperation is a viable option for late-stage valve failure, even after extended implant duration.
- Understanding late failure modes is crucial for managing patients with long-term prosthetic valves and for future device design.