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Risk Factors for Starr-Edwards Prosthetic Valve Dysfunction: New Insights into an Old Prosthesis

World Journal of Cardiovascular Diseases 2019年第3期9卷 149-157页

作者： grecia iveth maryelis raymundo-martinez Rodrigo Gopar-Nieto Diego Araiza-Garaygordobil Pablo Martínez-Amezcua Alejandro Cabello-Lopez Laura Leticia Rodríguez-Chavez Nilda Espinola-Zavaleta Cardiology Fellow-In-Training Instituto Nacional de Cardiologia Ignacio Chavez Mexico City Mexico Coronary Care Unit Instituto Nacional de Cardiología Ignacio Chavez Mexico City Mexico Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore USA Occupational Health Research Unit Centro Medico Nacional Siglo XXI Mexico City Mexico Out-Patient Clinic Instituto Nacional de Cardiología Ignacio Chavez Mexico City Mexico Department 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Starr-Edwards prosthetic valves were used for valve replacement, but due to their high thrombogenic risk, they were withdrawn from market.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.

关键词： Prosthetic Valve Starr-Edwards Survival Valvular Heart Disease

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