Reoperation on a Starr-Edwards ball valve without structural deterioration.

Accurate measurement of pressure gradients on echocardiography across a Starr-Edwards (SE) ball valve is difficult due to its unique flow pattern. The decision of indication for reoperation on the valve requires multifactorical evaluation. We report a surgical case with an aortic SE ball valve 43 years after implantation. There was no apparent structural deterioration on the ball per se, yet, remarkable pannus formation was noted beneath the sewing cuff in the left ventricular outflow tract.