Mitral valve replacement with cloth covered composite seat prostheses. The case for early operation

A review of 4 years' experience with the cloth covered composite seat Starr Edwards mitral valve prosthesis indicates a substantial reduction in early and late mortality rates as well as in complications related to the use of a prosthesis. In patients who had mitral valve replacement (MVR) with this prosthesis, functional results were infrequently influenced by operative or valve related complications. The most important determinants of postoperative functional class were the preoperative duration of symptoms and the response to medical management. In view of these findings, MVR with the current prosthesis may reasonably be offered early to moderately disabled patients with recent clinical deterioration who respond to medical treatment. It should no longer be restricted only to those with severe disability who can no longer respond to medical therapy.