Author(s)

Grecia Iveth Maryelis Raymundo-Martinez¹, Rodrigo Gopar-Nieto¹, Diego Araiza-Garaygordobil², Pablo Martínez-Amezcua³, Alejandro Cabello-Lopez⁴, Laura Leticia Rodríguez-Chavez⁵, Nilda Espinola-Zavaleta^6*

¹Cardiology Fellow-In-Training, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
²Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico.
³Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
⁴Occupational Health Research Unit, Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
⁵Out-Patient Clinic, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico.
⁶Department of Nuclear Cardiology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.

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Starr-Edwards prosthetic valves were used for valve replacement, but due to their high thrombogenic risk, they were withdrawn from market.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.

Prosthetic Valve, Starr-Edwards, Survival, Valvular Heart Disease

Raymundo-Martinez, G. , Gopar-Nieto, R. , Araiza-Garaygordobil, D. , Martínez-Amezcua, P. , Cabello-Lopez, A. , Rodríguez-Chavez, L. and Espinola-Zavaleta, N. (2019) Risk Factors for Starr-Edwards Prosthetic Valve Dysfunction: New Insights into an Old Prosthesis. World Journal of Cardiovascular Diseases, 9, 149-157. doi: 10.4236/wjcd.2019.93014.