Aortic valve replacement: a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses

Albert Starr, G. L. Grunkemeier, L. E. Lambert, D. R. Thomas, S. Sugimura, E. A. Lefrak

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or 'track' model since 1972. The 5-yr actuarial survival rate for operative survivors is about 80% for both non-cloth-covered and cloth-covered valves, while the 10-yr survival is 61%, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 yrs are 7% for the cloth-covered and 9% for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8% incidence at 5-yr compared to a 22% incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The 'track' valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean followup period 1 yr) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.

Original languageEnglish (US)
Pages (from-to)133-139
Number of pages7
JournalCirculation
Volume56
Issue number3 suppl. 2
StatePublished - 1977

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Aortic Valve
Prostheses and Implants
Reoperation
Incidence
Thromboembolism
Transient Ischemic Attack
Survivors
Survival Rate
Metals
Survival
Wounds and Injuries

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Starr, A., Grunkemeier, G. L., Lambert, L. E., Thomas, D. R., Sugimura, S., & Lefrak, E. A. (1977). Aortic valve replacement: a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses. Circulation, 56(3 suppl. 2), 133-139.

Aortic valve replacement : a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses. / Starr, Albert; Grunkemeier, G. L.; Lambert, L. E.; Thomas, D. R.; Sugimura, S.; Lefrak, E. A.

In: Circulation, Vol. 56, No. 3 suppl. 2, 1977, p. 133-139.

Research output: Contribution to journalArticle

Starr, A, Grunkemeier, GL, Lambert, LE, Thomas, DR, Sugimura, S & Lefrak, EA 1977, 'Aortic valve replacement: a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses', Circulation, vol. 56, no. 3 suppl. 2, pp. 133-139.
Starr A, Grunkemeier GL, Lambert LE, Thomas DR, Sugimura S, Lefrak EA. Aortic valve replacement: a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses. Circulation. 1977;56(3 suppl. 2):133-139.
Starr, Albert ; Grunkemeier, G. L. ; Lambert, L. E. ; Thomas, D. R. ; Sugimura, S. ; Lefrak, E. A. / Aortic valve replacement : a ten-year follow-up of non-cloth-covered vs cloth-covered caged-ball prostheses. In: Circulation. 1977 ; Vol. 56, No. 3 suppl. 2. pp. 133-139.
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abstract = "From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or 'track' model since 1972. The 5-yr actuarial survival rate for operative survivors is about 80{\%} for both non-cloth-covered and cloth-covered valves, while the 10-yr survival is 61{\%}, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 yrs are 7{\%} for the cloth-covered and 9{\%} for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8{\%} incidence at 5-yr compared to a 22{\%} incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The 'track' valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean followup period 1 yr) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.",
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AB - From 1965 to 1976, 721 isolated aortic valve replacements were performed at the University of Oregon hospitals, utilizing Starr-Edwards caged-ball prostheses. Three models of aortic prostheses were introduced during this period: a non-cloth-covered model has been in continuous use since 1965; a cloth-covered model was begun in 1968 and has been supplanted by the modified composite-strut or 'track' model since 1972. The 5-yr actuarial survival rate for operative survivors is about 80% for both non-cloth-covered and cloth-covered valves, while the 10-yr survival is 61%, based on the older model only. The actuarially-determined percentages of patients experiencing significant thromboembolic episodes (i.e., all except transient ischemic episodes) at 5 yrs are 7% for the cloth-covered and 9% for the non-cloth-covered model. If transient ischemic attacks are included, the cloth-covered model has only an 8% incidence at 5-yr compared to a 22% incidence for the older model. However, the cloth-covered valves are subject to a higher risk of reoperation because of the possibility of cloth injury. The 'track' valve, therefore, was designed with exposed metal on the inner surface of each strut to prevent ball-cloth contact. In 107 patients (mean followup period 1 yr) receiving anticoagulation, this prosthesis has maintained the same low incidence of thromboembolism as the previous cloth-covered model, with no reoperations for valve failure.

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