Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
INTRODUCTION. Cardiac valve diseases have been a focus of study and continuous evolution, since there are selected groups of patients in whom valve replacement is part of their therapy. In 1960, the caged sphere valve prosthesis model of Albert Starr and Lowell Edwards was developed. The design was refined and is still used today because it shows acceptable clinical results. OBJECTIVE. To describe the case of a patient with one of the first prototypes of Starr-Edwards metallic heart valve prosthesis, which has been in use and functional for more than 40 years. CLINICAL CASE. Male patient with Starr-Edwards prosthesis in aortic position, who to
date has been used for more than 40 years, maintains functional class II of the New York Heart Association, performing anticoagulation with Warfarin as well as strict controls of the international normalized index. DISCUSSION. The evaluation and follow-up of valve prosthesis carriers is essential to analyze clinical manifestations (dyspnea) and findings in laboratory or imaging tests (ultrasound) for the clinical and hemodynamic control of the patient, with the intention of contemplating circumstances that could determine the new valve intervention. CONCLUSIONS. Metallic valves, particularly those of the Starr-Edwards prosthesis type, present a high thrombotic risk and it is therefore advisable to maintain full anticoagulation, avoiding very high values of the international normalized index that could create scenarios of hemorrhagic events. Several patients carrying one of the older prostheses, such as the Starr-Edwards prosthesis model, may
have better survival and acceptable clinical results.
Castañeda-Porras O. Revisión de la evidencia de estudios de supervivencia de pacientes con prótesis valvular biológica. Rev. Colomb. Cardiol. 2019;26(6):328-337. Disponible en:
https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1115589
Vahanian A, Beyersdorf F, Praz F, Milojevic M, Baldus S, Bauersachs J, et al. Directrices ESC/EACTS 2021 para el
tratamiento de la cardiopatía valvular: desarrolladas por el grupo de trabajo para el tratamiento de la cardiopatía valvular de la Sociedad Europea de Cardiología (ESC) y la Asociación Europea de Cirugía Cardiotorácica (EACTS). Eur. Heart J. 2022;43:7,561–632.
DOI: https://doi.org/10.1093/eurheartj/ehab395
Chaikof EL. The development of prosthetic heart valves--lessons in form and function. N Engl J Med. 2007 Oct
;357(14):1368-71. Available from:
https://pubmed.ncbi.nlm.nih.gov/17914037/
Rajput FA, Zeltser R. Reemplazo de válvula aórtica. StatPearls [Internet]. Treasure Island (FL): Publicación de StatPearls; 2022 ene-. Disponible en:
https://www.ncbi.nlm.nih.gov/books/NBK537136/
Otto C, Nishimura R, Bonow R, Carabello B, Erwin J, Gentile F, et al. Guía ACC/AHA 2020 para el manejo de
pacientes con enfermedad cardíaca valvular: resumen ejecutivo. J Am Coll Cardiol. febrero de 2021, 77 (4) 450–500. Disponible en:
https://www.siacardio.com/consejos/enfermedades-valvulares/editoriales-enfermedades-valvulares/
guiasacc/
Tarasoutchi F, Montera MW, Ramos AIO, Sampaio RO, Rosa VEE, Accorsi TAD, Santis A, et al. Atualización de las
Directrices Brasileiras de Valvopatias. Arq. Bras. Cardiol. 2020;115(4):720-75. Disponible en:
https://pubmed.ncbi.nlm.nih.gov/33111877/
De Souza Beck AL. My Approach to Echocardiographic Evaluation of Valve Prosthesis: Como eu faco ecocardiográfica das Prótesis Valvares. Arq Bras Cardiol: Imagem cardiovasc. 2020;33(2):e000E5. Available from:
Raghuram K, Sasidharan B, Agarval A, Gangil N. TCTAP C-112 Reemplazo de válvula aórtica transcatéter en presencia de Prótesis Starr-Edward en posición mitral con prótesis expandible con balón - Desafíos técnicos. J Am
Coll Cardiol. 2021;77(14):S245-S247. Disponible en:
in_the_Presence_of_Starr-Edward_Prosthesis_in_Mitral_Position_Using_Balloon_Expandable_Prosthesis_-_Technical_Challenges
Raymundo Martínez G, Gopar Nieto R, Araiza Garaygordobil D, Cabello López A, Martínez Amezcua P, Farjat Ruiz J, Arias Mendoza A. A 51 year old Starr-Edwards caged ball valve. Arch Cardiol Mex. 2020; 90(3):361-362. Available from:
https://pubmed.ncbi.nlm.nih.gov/32952157/
Amrane M, Soulat G, Carpentier A, Jouan J. Starr-Edwards aortic valve: 50+ years and still going strong: a case
report. Eur Heart J Case Rep. Dec. 2017;1(2):ytx014. Available from:
https://pubmed.ncbi.nlm.nih.gov/31020072/
Dimitrakakis G, Wheeler R, Von Oppell U. Starr-Edwards mitral valve - 48 years till redo surgery, with over
years of patient survival after primary mitral valv replacement. Interact Cardiovasc Thorac Surg. 2021;
:33(4):640-642. Avialable from:
https://pubmed.ncbi.nlm.nih.gov/33954795/
Masiello P, Citro R, Mastrogiovanni G, et al. Prótesis Mitral de bola enjaulada, explantada después de 50 años.
J Am Coll Cardiol Case Rep. 2021 Jun, 3 (6) 884–887. Disponible en:
https://www.jacc.org/doi/abs/10.1016/j.jaccas.2021.03.029
Powell S, Choxi R, Gunda S, Jovin I. A 43 year old functional Starr-Edwards ball and cage mechanical aortic valve. Gen Thorac Cardiovasc Surg. 2021; 69(1): 97–99.
DOI: 10.1007/s11748-020-01383-6.
Hatton GE, Tanaka A, Estrera AL. Ascending aortic aneurysm repair 44 years after Starr-Edwards caged-ball
aortic valve replacement. Eur J Cardiothorac Surg. 2018 Nov 1;54(5): 962-963.
DOI: https://doi.org/10.1093/ejcts/ezy161
Sabouni MA, Baumeister RH, Traverse P. 49 years of normal functioning Starr-Edwards aortic valve prosthesis.
Oxf Med Case Reports. 2020 Feb 24;2020(2):omz141. Available from:
https://pubmed.ncbi.nlm.nih.gov/32123569/
Tsuji S, Imamura Y, Saito D, Tabayashi A, Koizumi J, Tsuboi J, et al. Valve Re-replacement after Aortic Valve Replacement with Starr-Edwards Ball Valve Fortyfive years Ago: Repor of a Case. Kyobu Geka. Mar 2021; 74(3):
-223. Available from:
https://pubmed.ncbi.nlm.nih.gov/33831878/
Dias S, Bueno R, Crozatti L, Cordeiro J, Dueñas Accorsi T, Egipto Rosa V, et al. Starr-Edwards valve prosthesis
half a century of durability. Rev Soc Cardiol. 2019;29(2):201-2. Available from:
Chagas Martins T, Modesto dos Santos V, Cobra Negreiros S. Longa duracao de prétese tipo Starr-Edwards produzida e implantada no Hospital de Base do Distrito Federal. Brasilia Med. 2021; 58:1-5.
DOI: 10.5935/2236-5117.2021v58a67
Obaid DR, Smith D, Gilbert M, Ashraf S. Computer simulated “Virtual TAVR” to guide TAVR in the presence of
a previous Starr-Edwards mitral prosthesis. J Cardiovasc Comput Tomogr. 2019;13(1):38-40. Available from: https://www.researchgate.net/publication328186314_Computer_simulated_Virtual_TAVR_to_guide_TAVR_in_the_presence_of_a_previous_Starr-Edwards_mitral_prosthesis
Greason K, Sandhu G, Nkomo V, King K, Joyce D, Williamson E, et al. Transcatether aortic valve insertion after
previous mitral valve operation. J Thorac Cardiovasc Surg. Sept 2017: 154(3):810-815. Available from: https://www.sciencedirect.com/science/article/pii/S0022522317306372
Raghuram K, Sasidharan B, Agarwal A, Gangil N. TCTAP C-112 TCTAP C-112 Trans Catheter Aortic Valve
Replacement in the Presence of Starr-Edward Prosthesis in Mitral Position Using Balloon Expandable Prosthesis - Technical Challenges. Desafíos técnicos. J Am Coll Cardiol. 2021;77(14_Supplement):245–247. Available from: https://www.jacc.org/doi/10.1016/j.jacc.2021.03.286 -
US. National Museum of American History [Internet].Starr-Edwards Heart Valve Prosthesis. [citado el 13 de
mayo de 2022]. Available from:
https://americanhistory.si.edu/collections/search/object/nmah_735412
The authors who publish in this journal accept the following conditions:
1. The authors retain the copyright and grant to the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM the right of the first publication, with the work registered with the Creative Commons attribution license, which allows third parties to use the published material provided that they mention the authorship of the work and the first publication in this journal.
2. Authors can make other independent and additional contractual agreements for the non-exclusive distribution of the version of the article published in this journal (for example, include it in an institutional repository or publish it in a book) as long as it clearly indicates that the work was published. for the first time in the CAMbios MEDICAL-SCIENTIFIC JOURNAL HECAM.
