Patient Lives Almost 50 Years after Aortic Valve Replacement with a Starr-Edwards Caged-Ball Valve
To the Editor:
Yalcinkaya and colleagues1 reported the case of a patient whose mitral Starr-Edwards caged-ball valve (SECBV) was still working after 41 years. The authors referred to 2 other mitral SECBV carriers alive at 44 and 45 years. From their own experience, Starr and Grunkemeier2 reported their longest-term survivors at 44.4 years (mitral position) and 51.7 years (aortic position). We also had an aortic valve recipient who lived for nearly 50 years.
On 17 April 1964, a 10-year-old boy underwent aortic valve replacement with an SECBV at a different hospital. After discharge, all his postoperative monitoring occurred in our hospital. Through the years, transthoracic echocardiograms (TTEs) showed good performance of the prosthetic aortic valve. In 2009, when the patient underwent successful ablation of supraventricular tachycardia at age 45 years, TTE and cardiac catheterization revealed good aortic valve function. On 19 January 2014, he underwent urgent cardioversion of ventricular tachycardia. Results of radiographic and fluoroscopic examination indicated normal valvular function. A TTE revealed a peak gradient of 41 mmHg, a mean gradient of 21 mmHg, and normal left ventricular function. Four days later, the 59-year-old patient died of refractory ventricular fibrillation—49 years, 9 months, 7 days after valve replacement. No autopsy was performed.
Given so few reports of well-functioning SECBVs beyond 40 years,3–5 we think that our patient's survival for almost 50 years without valvular dysfunction is noteworthy.
