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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 746-752, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Mechanical valves: a comparative analysis of the Starr-Edwards and Bjork-Shiley prostheses

DA Murphy, FH Levine, MJ Buckley, L Swinski, WM Daggett, CW Akins and WG Austen

Despite the requirement of anticoagulation, mechanical valve prostheses offer the advantage of proven durability. We have compared the long- term results of 467 aortic valve replacements and 342 mitral valve replacements using the Starr-Edwards prosthesis with 110 aortic valve replacements and 105 mitral valve replacements using the Bjork-Shiley prosthesis from 1973 through 1977. Improvement in New York Heart Association (NYHA) class was noted in greater than 80% of patients in all four groups. Long-term survival with mean follow-up over 5 years was not significantly different between respective groups. The probability of thromboembolic complications, however, was significantly higher (p less than 0.05) with the Starr-Edwards prosthesis in both the aortic and mitral positions. The probability of valve failure, although low for all groups, was significantly higher (p less than 0.05) in the Bjork-Shiley mitral group due to late thrombotic occlusion. Use of the Starr-Edwards and Bjork-Shiley prostheses is associated with satisfactory functional improvement and similar long-term survival rate. However, the increased risk of valve failure due to late thrombotic occlusion of the Bjork-Shiley prosthesis should be considered when choosing a mechanical mitral prosthesis.


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