Starr-Edwards Caged-ball Valve Research Articles

A 51-year-old Starr–Edwards caged-ball valve

A 51-year-old Starr–Edwards caged-ball valve

Is a Mechanic Prosthetic Valve in Tricuspid Position an Absolute Impediment to Implant a Definitive Electrode in the Right Ventricle?

This is the case of a middle-aged woman with Ebstein anomaly, who had a tricuspid valve replacement with a mechanic Starr-Edwards caged-ball valve many years ago, and needed an implantable cardioverter defibrillator (ICD) and ventricular pacing due to ventricular tachycardia and atrioventricular block with syncope. Furthermore, she has a chronic respiratory disease that make open chest surgery inadvisable. Prosthetic valves are a real obstacle to cross them and place catheters in the distal chamber. This report shows a technique to get access to the right ventricle endocardium through the annulus and placing the ICD electrode with correct sensing and pacing.

Giant left atrium in a patient with Starr–Edwards caged ball implanted three decades ago

The Starr–Edwards caged ball valve is one of the oldest cardiac valve prostheses and was widely used all around the world in the past decades [1]. Few patients are reported to have lived with Starr–Edwards prosthesis for 30 years or longer. A 64-year-old woman was admitted to our hospital with complaints of dyspnea on exertion (NHYA Class III), abdominal distention, peripheral swelling, and diminished appetite. She underwent mechanical mitral replacement with Starr–Edwards caged ball valve prosthesis due to rheumatic mitral valve disease (predominantly severe mitral regurgitation) at age 34. She underwent DDD-R pacemaker implantation 5 years ago due to syncope resulting from sick sinus syndrome. On resting ECG basic rhythm was atrial fibrillation. The patient was well anticoagulated with INR value of 3.7. On transthoracic echocardiogram, the silicon ball was free to travel along the cage over a distance of 1 cm, although high peak velocity (2.5 m/s) accompanied with 8 mmHg of mean gradient and 130 ms of pressure half time was observed on transthoracic echocardiography examination. The latter also demonstrated a giant left atrium with dimensions of 15×12 cm, severe tricuspid insufficiency associated with pulmonary hypertension (systolic pulmonary arterial pressure=75 mmHg), and reduced right ventricular systolic functions. Occluder motion was normal, and no

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound: A Report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, Developed in Conjunction With the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound: A Report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, Developed in Conjunction With the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the

Extended Durability of a Cloth-Covered Star-Edwards Caged Ball Prosthesis in Aortic Position

The Starr-Edwards caged ball valve is one of the oldest cardiac valve prosthesis and was widely used all around the world in the past decades. Despite the long-term results that have been reported there are only a few cases reported that exceed 30 years of durability. Here in, we report a 53-year-old patient with a well-functioning 35-year-old aortic Starr-Edwards caged ball prosthesis.

The ‘old friend’ is not alone at work

We have read the recent case report by Ikizler et al. [1] with great interest. The authors reported an interesting case with Starr–Edwards caged-ball valve with 34 years durability without anticoagulant or antithrombotic treatment for 24 years. Authors discussed long durability of a prosthetic aortic valve with details. In addition to their valuable contribution, we just wished to emphasize long term durability of prosthetic heart valves without anticoagulant therapy with the following reports. We have reported a case with functioning aortic Bjork– Shiley prosthetic heart valve for 22 years without anticoagulation [2]. Our case had never received anticoagulant or antithrombotic therapy in postoperative period due to incompliance. Evaluation with echocardiography and cinefluoroscopy revealed functioning aortic valve, and warfarin was prescribed to the patient. In the literature, similar cases with mechanical valves without anticoagulant treatment for long

An old friend is still at work: 34-year-old well functioning Starr–Edwards aortic prosthesis without anticoagulation

The Starr–Edwards caged-ball valve prosthesis is the beginning mark of the valve replacement era, and was used widely in many centers worldwide in the past decades. Despite long term results with this prosthesis have been reported with satisfactory hemodynamic performance, only a few cases have been reported exceeded 30 years of durability. We report the case of a patient with a 34-year-old well-functioning Starr–Edwards ball prosthesis in aortic position using neither antiaggregant nor anticoagulant therapies.

Reoperation for a patient with starr-edwards aortic valve malfunction due to pannus formation twenty-nine years after implantation

We report a re-do case of severe aortic valve stenosis due to pannus formation 29 years after an aortic Starr-Edwards caged-ball valve implantation. A huge shelf of calcified and thick pannus tissue below the valve had reduced the already small orifice by at least a third in surface area. The explanted Starr-Edwards valve revealed no mechanical or structural failure. Early detection and treatment of pannus outgrowth is essential in order to prevent life-threatening prosthetic valve malfunctions.

Laser Anemometry Measurements of Steady Flow Past Aortic Valve Prostheses

An experimental investigation was conducted in steady flow to examine the fluid dynamics performance of three prosthetic heart valves of 27 mm diameter: Starr-Edwards caged ball valve, Bjork-Shiley convexo-concave tilting disk valve, and St. Vincent tilting disk valve. It was found that the pressure loss across the St. Vincent valve is the least and is, in general, about 70 percent of that of the Starr-Edwards valve. The pressure recovery is completed about 4 diameters downstream. The velocity profiles for the ball valve reveal a large single reversed flow region behind the occluder while those for the tilting disks valves reveal two reversed flow regions immediately behind the occluders. Small regions of stasis are also found near the wall in the minor opening of Bjork-Shiley valve and in the major opening of St. Vincent valve. The maximum wall shear stresses of the three valves at a flow rate of 30 l/min are in the range 30-50 dyn/cm2 which can cause hemolysis of attached red blood cells. The corresponding maximum Reynolds normal stresses are in the range of 1600-3100 dyn/cm2. The Reynolds normal stresses decay quickly and return approximately to the upstream undisturbed level at about 4 diameters downstream while the wall shear stresses decay at a slower rate. The maximum Reynolds normal stresses occur at about 1 diameter downstream while the maximum wall shear stress is at about 2 diameters downstream. In general, the St. Vincent valve has better performance.(ABSTRACT TRUNCATED AT 250 WORDS)