Starr-Edwards

[Marty]

Starr–Edwards Heart Valves





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A 67-year-old woman presented with dyspnea and peripheral edema due to severe tricuspid regurgitation. Having had rheumatic heart disease, she had undergone replacement of the mitral and aortic valves with Starr–Edwards heart valves 38 years earlier. During her recent admission, echocardiography showed a transaortic valve gradient of 18 mm Hg, a transmitral valve gradient of 4 mm Hg, and elevated systolic pressure, at 70 mm Hg, in the pulmonary artery. She underwent a preoperative right and left heart catheterization for tricuspid-valve replacement; both mechanical mitral and aortic valves were functioning normally (Panel A, systolic phase, aortic valve open, arrow; Panel B, diastolic phase, mitral valve open, arrow; see video). In 1960, Dr. Albert Starr and Lowell Edwards, an electrical engineer, achieved successful implantation of the Starr–Edwards valve in the mitral position. As seen in this patient, the Starr–Edwards heart valve can function for well over three decades.




Nicolo Piazza, M.D.
Jean Gregoire, M.D.
Montreal Heart Institute
Montreal, QC H1T 1C8, Canada
[email protected]




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[Duff Man]

this might bea little off topic, but i don't think the starr-edwards valve has a vibration/thrill like the modern bi leaflet valves do (on-x valves claim to not have a thrill). I think that vibration/thrill is bad news, myself.

The Thrill is Gone!
With On-X aortic valves, surgeons report an absence of a "thrill" within the aorta of implanted patients.

What Thrill?
Following implantation of an aortic valve prosthesis and removal of the cross-clamp, many surgeons pause to palpate the patient's aorta. This habit provides a tactile confirmation that the implanted valve is functioning properly. With bileaflet mechanical valves, surgeons report that they characteristically feel an unnatural "thrill" (vibration) in the aorta.

The absence of thrill with On-X valves is a further indication that efforts to reduce turbulence have met with success. On-X valves are designed to emulate the natural flow of the native valve with hemodynamic features like the inlet flare, thinner orifice walls, natural length and fully opening leaflets.

 

[Mary]

Marty,

My husband receives the online NEJM, and he had bookmarked it for me to look at. I thought about sending it on to RCB, but maybe he will check in and see your thread.

By the way, in the same section it had an image of the descending aorta with a question as to what caused it to be so mishapened. Did you see that? It was the result of osteoporosis!

 

[Arlyss]

When I toured the Edwards museum in 2006, we were told that this ball-in-cage is still manufactured and used in countries that cannot afford the newer but more expensive valve models.

Arlyss