Fractured occluder disc: A previously unrecognized complication of the Starr-Edwards disc prosthesis

Fracture of the occluder disc of a low-profile Starr-Edwards prosthesis is a hitherto unrecognized complication. We describe a patient who presented w ith right heart failure and severe pulmonary hypertension 27 years after mi tral valve replacement with a model 6520 caged-disc prosthesis, At surgery, there was a longitudinal split in the occluder disc, and organized thrombu s was lodged between the split segments. This case offers a unique opportun ity to study the long-term effects of wear on the polyethylene poppet and S tellite cage.