Survival after Starr-Edwards aortic valve replacement

A series of 507 patients who underwent Starr-Edwards aortic valve replacement is reported. Four hundred fifty-five of these patients were adequately followed an average of 36 months. Of this number, 339 patients (75%) are alive, and 116 (25%) have died. There was an operative mortality of 10.8% and a late mortality of 13.4%. Patients with mixed aortic stenosis and regurgitation had a significantly lower cumulative mortality than patients with pure stenosis or regurgitation. Complications related to the valvular prosthesis itself were frequent. Although the great majority were minor, prosthetic complications caused a significant number of deaths and considerable morbidity. Myocardial disease was the other significant limiting factor in survival. Preoperative cardiac index and functional classification were valuable in predicting long-term survival, but age at time of surgery and type of preoperative symptoms were of lesser prognostic value.