Starr-Edwards Valve Explantation After 40 Years

Q: What does this research mean for the field?

A Starr-Edwards ball-in-cage mechanical aortic valve can maintain normal mechanical function without dysfunction for up to 40 years. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Joshua Crane; Mark S. Slaughter

doi:10.1016/j.atssr.2026.02.031

March 1, 2026Annals of Thoracic Surgery Short ReportsOpen Access

Starr-Edwards Valve Explantation After 40 Years

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Key Points

To describe the surgical explantation of a normally functioning Starr-Edwards ball-in-cage mechanical aortic valve 40 years after implantation.
Evaluated a 61-year-old patient presenting with a 6.8-cm ascending and aortic root aneurysm who had undergone aortic valve replacement at age 21 for endocarditis.
Assessed prosthetic hemodynamic function during chronic anticoagulation therapy with warfarin.
Performed surgical replacement of the aortic valve and root alongside explantation of the intact ball-in-cage prosthesis.
The Starr-Edwards ball-in-cage valve demonstrated normal hemodynamic function with no evidence of structural valve deterioration or failure over 40 years.
Valve explantation and root replacement were prompted exclusively by the progression of an enlarging 6.8-cm aortic root aneurysm.

Population

A 61-year-old patient with an enlarging ascending and aortic root aneurysm

Design

Case report

Follow-up

40 years

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Implication

Reports explantation of a functional Starr-Edwards ball-in-cage valve after 40 years due to an ascending aortic aneurysm, demonstrating exceptional mechanical prosthetic durability.

Abstract

A 61-year-old patient was referred for an enlarging ascending and aortic root aneurysm, which measured 6.8 cm (Supplemental Video 1). At age 21, the patient underwent an aortic valve replacement with a Starr-Edwards ball-in-cage valve (Figure 1) at another hospital for aortic valve endocarditis. The patient had been maintained on warfarin and done well for 40 years, with no evidence of valve dysfunction (Supplemental Videos 2 and 3). Now, the patient required aortic valve and root replacement with explantation of the Starr-Edwards ball-in-cage valve.

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Cite This Study

Crane et al. (2026) studied this question.

synapsesocial.com/papers/6a025ccbedf6f481385949c3 https://doi.org/10.1016/j.atssr.2026.02.031

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Starr-Edwards Valve Explantation After 40 Years

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Starr-Edwards Valve Explantation After 40 Years

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Implication

Abstract

Discussion

Cite This Study

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