Thromboembolism after Starr valve replacement.

One hundred and six patients who left hospital after Starr-Edwards ball valve replacements have beenfollowedfor a period of 6 months tO 4 years. All patients were maintained on oral anticoagulant therapy so that a prothrombin ratio of approximately I 7:I was attained. Four patients suffered minor nose bleeds. During the period offollow-up there have been 4 patients who have suffered embolic phenomena, one ofwhich provedfatal. The site of thrombusformation in thefatal case was the left atrium and not the prosthetic valves. The relatively low incidence of embolic and haemorrhagic complications can be added to the satisfactory immediate and late function of the valves themselves. Minor leaks have developed around 7 per cent of surviving aortic valve replacements but no mitral or tricuspid valve shows evidence of regurgitation. No case of valve failure has occurred.