Gastroduodenal damage induced by anti-inflammatory drugs: Authors' reply

Abstract

causing low output and death. In the remaining 21 patients the cause of death was unrelated to mechanical valve failure. All of the patients in whom this phenomenon of triangulation of the aortic root was noted had undergone aortic valve replacement using the Starr-Edwards model No 2320, in which the three cage struts are cloth covered. This model was discontinued in 1976 and the current models use three stellite struts without the cloth covering. While the older models probably had greater potential to cause outflow obstruction with incorporation of the cloth covered struts into the aortic wall, the tendency to cause triangular deformity with this style of valve prosthesis remains. Although the risk of acute failure and the operative mortality associated with artificial heart valves are small, the medium and long term morbidity is not negligible. Current mechanical prostheses may well prove superior to those used previously but they are not trouble free. Conservative valve reconstruction needs to be encouraged.