Abstract
Background: Starr-Edwards prosthetic valves were used for valve replacement, but due to their high thrombogenic risk, they were withdrawn from market. Nevertheless, there are some cases of Starr-Edwards prosthetic valve carriers that have shown long-term survival reaching up to 50 years. The objective of this study was to determine survival in 12 patients with mechanical Starr-Edwards prosthetic valve and risk factors for predicting valve dysfunction. Methods: Cross-sectional study of patients who had valve replacement with a Starr-Edwards prosthetic valve in a single center from 1968 to 1990. Socio-demographic data, valvular dysfunction variables and mortality were recorded. Logistic regression models to determine valvular dysfunction were constructed. Survival was analyzed with Cox regression and Kaplan-Meier survival curves. Results: A total of 12 patients were analyzed. The median age was 59 years (48.5 - 64). Eleven patients had normal right and left ventricular function. The most common cause of valve replacement was rheumatic valve disease (75%) and it was more frequently in mitral position (50%). Valvular dysfunction was detected in 3 patients (25%). Atrial fibrillation had the highest association with valvular dysfunction (P = 0.005). Stroke was seen in 25% of the population and the overall mortality was 33.3%. Conclusions: The survival of patients with Starr-Edwards prosthetic valve was 66.66% in the 50-year follow-up. Atrial fibrillation had the highest association with prosthetic valvular dysfunction.
Highlights
Rheumatic heart disease (RHD) is one of the leading diseases in low and middle-income countries and accounts for up to 1.4 million deaths per year
Starr-Edwards prosthetic valves were used for valve replacement, but due to their high thrombogenic risk, they were withdrawn from market
The purpose of this study was to determine the survival in a series of patients with Starr-Edwards prosthetic valves and to analyze the risk factors predicting prosthetic valvular dysfunction
Summary
Rheumatic heart disease (RHD) is one of the leading diseases in low and middle-income countries and accounts for up to 1.4 million deaths per year. They reported a lineal rate of complications expressed in percentage of patients per year of 2% ± 0.2 for thromboembolism, 2.1% ± 0.2 for bleeding related to vitamin K antagonists, 0.5% ± 0.1 for infective endocarditis, 0.3% ± 0.1 for other complications, and total of adverse events of 4.8% ± 0.1 [5] They did not find thrombotic occlusions or valvular dysfunction, during his follow-up [6]. The purpose of this study was to determine the survival in a series of patients with Starr-Edwards prosthetic valves and to analyze the risk factors predicting prosthetic valvular dysfunction. Atrial fibrillation had the highest association with prosthetic valvular dysfunction
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