Non-cloth-covered caged-ball prostheses. The second decade

The Starr-Edwards Models 6120 mitral and 1200/60 aortic valves are caged-ball prostheses with cloth-covered sewing rings and bare-metal struts. Introduced in 1965, they have been in continuous clinical use longer than any other currently available heart valve prostheses. Late results with this valve are analyzed and compared with recent series employing other current valve prostheses. One hundred thirty-four mitral 6120 prostheses were inserted at the University of Oregon Health Sciences Center from 1965 through 1977, with 118 postoperative survivors followed for a mean of 5.4 years. Twelve-year survival rate (±standard error) was 50 (±8) percent. Twelve percent of late deaths were valve related. Eighty-eight (±5) percent of valves were still in place at 12 years. The embolic rate was 5.8 (±1.0) percent per patient-year for all emboli and 2.2 (±0.6) percent per patient-year for serious emboli. Two hundred forty-nine operative survivors among 282 patients undergoing aortic valve replacement during the same period of time were followed for a mean of 4.3 years. Twelve-year survival was 61 (±6) percent and the removal-free rate was 92 (±5) percent. Six percent of late deaths were valve related. Embolic rates were 5.0 (±.7) percent and 1.8 (±.4) percent per patient-year for all emboli and serious emboli, respectively. Structural failure, specifically ball variance, was not encountered with this prosthesis. Ninety percent of 10 year survivors are in N.Y.H.A. Functional Class I or II. There was one anticoagulant-related death in 1,698 patient-years of follow-up. The current non-cloth-covered caged-ball valves provide unquestionable durability and well-documented results into their second decade of use. They provide a base line for comparison with newer prostheses and offer a valid, current choice for both aortic and mitral valve replacement.