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

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

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


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
Issue number3 suppl. 2
StatePublished - 1977
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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