Reoperation for a Starr-Edwards aortic prosthetic valve 33 years after initial implantation

Use of the Bentall method for replacement of an aortic Starr-Edwards ball valve prosthesis implanted 32 years previously

We report the case of a 54-year-old woman who, 32 years previously, had undergone replacement of the ascending aorta by the inclusion method with a Starr-Edwards ball valve prosthesis and recently underwent aortic root re-reconstruction by the Bentall method. Routine chest radiography revealed dilatation of the mediastinum, and computed tomography revealed an aneurysm of the ascending aorta. At reoperation, although the cloth covering the cage of the Starr-Edwards ball valve prosthesis appeared worn and some pannus formation was seen, the Starr-Edwards ball valve was functioning normally. The aortic root was replaced with a composite graft that consisted of a 23-mm St. Jude bileaflet prosthesis and a 24-mm Hemashield gold graft. The patient was discharged from the hospital in good condition 25 days after surgery.