Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Fukutsu, Japan.
Circ J. 2013;77(1):105-8. doi: 10.1253/circj.cj-12-0906. Epub 2012 Sep 21.
The durability of the Starr-Edwards (SE) mitral caged-disk valve, model 6520, is not clearly known, and structural valve deterioration in the SE disk valve is very rare.
Replacement of the SE mitral disk valve was performed in 7 patients 23-40 years after implantation. Macroscopic examination of the removed disk valves showed no structural abnormalities in 3 patients, in whom the disk valves were removed at <26 years after implantation. Localized disk wear was found at the sites where the disk abutted the struts of the cage, in disk valves excised >36 years after implantation in 4 patients. Disk fracture, a longitudinal split in the disk along its circumference at the site of incorporation of the titanium ring, was detected in the valves removed 36 and 40 years after implantation, respectively, and many cracks were also observed on the outflow aspect of the disk removed 40 years after implantation.
Disk fracture and localized disk wear were found in the SE mitral disk valves implanted >36 years previously. The present results suggest that SE mitral caged-disk valves implanted >20 years previously should be carefully followed up, and that those implanted >30 years previously should be electively replaced with modern prosthetic valves
Starr-Edwards（SE）二尖瓣笼形碟阀模型 6520 的耐用性尚不清楚，SE 碟阀的结构性瓣膜退变非常罕见。
在植入后 23-40 年，有 7 名患者接受了 SE 二尖瓣碟阀置换。在 3 名患者中，移除的碟阀没有结构异常，他们的碟阀在植入后<26 年被移除。在植入后>36 年的 4 名患者中，在碟阀与笼架的支柱相接处发现局部碟片磨损。在植入后 36 年和 40 年分别移除的瓣膜中发现了碟片断裂，即钛环结合处的碟片沿圆周的纵向分裂，在植入后 40 年移除的碟片的流出面也观察到许多裂缝。
在植入>36 年前的 SE 二尖瓣碟阀中发现了碟片断裂和局部碟片磨损。目前的结果表明，应仔细随访植入>20 年前的 SE 二尖瓣笼形碟阀，对于植入>30 年前的瓣膜，应选择性地用现代人工瓣膜置换。
