yemenjmedYemen Journal of MedicinecoVolume 2 Issue 1MultidisciplinaryEnglishJanuary - April 2023 NNY20230510ArticleStarr Edwards Ball Caged Mechanical Heart Valves’ Reverberations – Need for a Phoenix of Analysis with a Critical Mindset EnglishY812Roman"EnglishNserif">Mark ChristopherArokiarajEnglishY10.32677/yjm.v2i1.3760The mechanical heart valve prosthesis with a caged ball has been around for 60 years. It has since experienced changes and adjustments. The Starr Edwards valve was a pioneer and was taken out of clinical use in the late 2000s. Starr Edwards is reportedly close to or has reached the age of 50, according to numerous sources from around the globe. The author's observations and review of the literature about thrombogenicity, pannus formation, left ventricular outflow tract obstructions, and infective endocarditis in the Starr Edwards valves, which were reportedly higher before its clinical ending, was only an overestimation and were not supported by scientific data. However, it was less discussed in the article, along with potential benefits. The main reasons for its demise were its obtrusive size and unattractive shape. There have been several successful implantations of these valves in Asian nations and reports of fewer primary failures and unexpected cardiac fatalities. Therefore, there is a need for extensive data gathering, documentation, and more recent studies on these valves to prepare for a prospective revival of use with newer research, mainly when long-term durability is considered.EnglishCaged Ball valves, Starr Edwards, Thrombogenicity, Durability, Safetyhttps://www.yemenjmed.com/admin/abstract?id=43References1619De Martino A, Milano AD, Barbera MD, et al. The Caged-Ball Prosthesis 60 Years Later: A Historical Review of a Cardiac Surgery Milestone. Tex Heart Inst J. 2022;49 (2): e207267.and;nbsp; Annete MM. The development of Starr Edwards valves. Tex Heart Inst J 1998;25:282-93.Dasi L, Simon H, Sucosky P, et al. Fluid mechanics of artificial heart valves. Clinical and Experimental Pharmacology and Physiology. 2009;36(2):225-237.Bloomfield P. Choice of heart valve prosthesis. Heart. 2002;87(6):583-589.and;nbsp;Raymundo-Martinez G, Gopar-Nieto R, Araiza-Garaygordobil D, et al. Risk Factors for Starr-Edwards Prosthetic Valve Dysfunction: New Insights into an Old Prosthesis. World Journal of Cardiovascular Diseases. 2019;09(03):149-157.Kafsi N, Trabelsi S, Acar P, et al. Comparaison des rand;eacute;sultats and;agrave; long terme des prothand;egrave;ses de Starr et de Saint-Jude en position mitrale [Comparison of long-term results of the Starr and Saint-Jude mitral valve prostheses]. Arch Mal Coeur Vaiss. 1991 Nov;84(11):1523-7. French.Lund O, Pilegaard HK, Ilkjaer LB, el al. Performance profile of the Starr-Edwards aortic cloth covered valve, track valve, and silastic ball valve. Eur J Cardiothorac Surg. 1999 Oct;16(4):403-13. doi: 10.1016/s1010-7940(99)00249-3.Starr A, Grunkemeier G. Beyond 24 years with the aortic Starr-Edwards Silastic Ball Valve: A valve of the past? and;mdash; no! European Journal of Cardio-Thoracic Surgery. 1993;7(3):113and;ndash;4.Macmanus Q, Grunkemeier G, Thomas D, et al. The Starr-Edwards model 6000 valve. A fifteen-year follow-up of the first successful mitral prosthesis. Circulation. 1977;56(4):623and;ndash;5.and;nbsp;Starr, A. The Starr-Edwards valve.and;nbsp;Journal of the American College of Cardiology. 1985; 6(4): 899and;ndash;903.and;nbsp;Forman R, Beck W, Barnard CN. Results after mitral valve replacement with cloth-covered Starr-Edwards prostheses (models 6300, 6310/6320, and 6400). Heart. 1978;40(6):612and;ndash;6.Edmunds LH Jr. Is prosthetic valve thrombogenicity related to design orand;nbsp;and;nbsp;and;nbsp; material?and;nbsp;Tex Heart Inst J. 1996;23(1):24-27.Orszulak TA, Schaff HV, Puga FJ, et al. Event status of the Starr-Edwards aortic valve to 20 years: a benchmark for comparison. Ann Thorac Surg. 1997 Mar;63(3):620-6.Miller DC, Oyer PE, Mitchell RS, Stinson EB, et al. Performance characteristics of the Starr-Edwards Model 1260 aortic valve prosthesis beyond ten years. J Thorac Cardiovasc Surg. 1984 Aug;88(2):193-207. Bessell JR, Gower G, Craddock DR. Thirty years experience with heart valve surgery: isolated aortic valve replacement. Aust N Z J Surg. 1996 Dec;66(12):799-805.Zouaoui W, Ouldzein H, Drissa MA, et al. Rand;eacute;sultats and;agrave; Court et long terme du remplacement valvulaire mitral par prothand;egrave;se mand;eacute;canique and;agrave; bille et and;agrave; ailettes (and;agrave; propos dand;rsquo;une sand;eacute;rie de 236 patients consand;eacute;cutifs avec un suivi moyen de 11 ans). Annales de Cardiologie et dand;#39;Angand;eacute;iologie. 2009;58(2):86and;ndash;93.and;nbsp;Murday AJ, Hochstitzky A, Mansfield J, et al. A prospective controlled trial of St. Jude versus Starr Edwards aortic and mitral valve prostheses. Ann Thorac Surg. 2003;76(1):66-73; discussion 73-4.Sezai A, Shiono M, Hata M, et al. 40 Years experience in mitral valve replacement using Starr-Edwards, St. Jude Medical and ATS valves. Ann Thorac Cardiovasc Surg. 2006 Aug;12(4):249-56.Gand;ouml;dje O. Thirty Years Survival after double valve replacement with Starr-Edwards prostheses in aortic and mitral position. European Journal of Cardio-Thoracic Surgery. 1997;11(2):391and;ndash;3.and;nbsp;and;nbsp;Emery RW, Krogh CC, Arom KV, et al. Th St Jude Medical cardiac valve prosthesis:A 25 year experience with single valve replacement. Ann Thorac Surg. 2005;79:776-83. Bonow RO, Carabello B, DeLeon AC, et al. ACC/AHA practice guidelines.Guidelines for the management of patients with valvular heart disease. J Am Coll Cardiol. 1998; 32:1486and;ndash;588. Hirji SA, Kaneko T, Aranki S. The revolution and evolution of mechanical valves: The ball has left the cage. The Journal of Thoracic and Cardiovascular Surgery. 2018;155(5).and;nbsp;Masotti C, De Castro C, Aquilina M, et al. Doppler hemodynamic characteristics of four widely used aortic valve prostheses. Minerva Cardioangiol. 1990;38(11):461-71.Chakraborty B, Quek S, Zee D, et al. Doppler Echocardiographic Assessment of Normally Functioning Starr-Edwards, Carbomedics and Carpentier-Edwards Valves in Aortic Position. Angiology. 1996;47(5):481-489. Williams GA, Labovitz AJ. Doppler hemodynamic evaluation of Prosthetic (Starr-Edwards and Bjand;ouml;rk-Shiley) and bioprosthetic (Hancock and Carpentier-Edwards) cardiac valves. The American Journal of Cardiology. 1985;56(4):325and;ndash;32.Grigg, L., Fulop, J., Daniel, L., et al. Doppler Echocardiography Assessment of Prosthetic Heart Valves. Echocardiography. 1990; 7: 97-114.and;nbsp; Panidis IP, Ross J, Mintz G. Normal and Abnormal Prosthetic Valve Function as Assessed by Doppler Echocardiography. JACC.1986; 8(2):317-26.Miller FA, Callhan JA, Taylor et al. Normal aortic valve prostheses hemodynamics: 609 prospective Doppler examinations. (Abstract) Circulation 1989; 80(Suppl II): IIand;ndash;169. Rosenhek R, Binder T, Maurer G, et al. Normal values for Doppler echocardiographic assessment of heart valve prostheses. J Am Soc Echocardiogr. 2003;16(11):1116-27.and;nbsp; Pelikan PCD, Chew PH, Fortuin NJ, et al. Left ventricular outflow obstruction caused by a Starr-Edwards mitral prosthesis. The American Journal of Cardiology. 1983;52(5):652and;ndash;3.and;nbsp;Shepherd RL, Glancy DL, Stinson EB, et al. Hemodynamic confirmation of obstruction to left ventricular inflow by a caged-ball prosthetic mitral valve. Case report. J Thorac Cardiovasc Surg. 1973 Feb;65(2):252-4. Jett GK, Jett MD, Barnhart GR, et al. Left ventricular outflow tract obstruction with mitral valve replacement in small ventricular cavities. The Annals of Thoracic Surgery. 1986;41(1):70and;ndash;4.and;nbsp;Nanda NC, Raymond G, Pravin SM, et al. Echocardiographic assessment of left ventricular outflow width in the selection of mitral valve prosthesis. Circulation. 1973;48(6):1208and;ndash;14.Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. New England Journal of Medicine. 2013;369(13):1206and;ndash;14.and;nbsp;Mendell J, Lee F, Chen S, et al. The effects of the antiplatelet agents, aspirin and naproxen, on pharmacokinetics and pharmacodynamics of the anticoagulant edoxaban, a direct factor Xa inhibitor. Journal of Cardiovascular Pharmacology. 2013;62(2):212and;ndash;21.and;nbsp;Kitano D, Migita S, Li Y, et al. Effect of rivaroxaban and clopidogrel combination therapy on in-stent responses after Everolimus-eluting stent implantation in a porcine coronary model. Journal of Atherosclerosis and Thrombosis. 2022;29(1):69and;ndash;81.and;nbsp;