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Two cases of malfunctioning Starr-Edwards cloth-covered mitral valve prostheses requiring reoperation are presented. Both cases underwent successful surgical repair 21 years after the valve replacement. The causes were a disturbance of the poppet during the opening movement due to excessive tissue ingrowth and a paravalvular leak associated with a tear of the valve seat. Replacement of the Starr-Edwards valve prosthesis more than 20 years after the initial installation has not been reported.
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