A Successful Design

M. Lowell Edwards Public History Project

A Successful Design

Albert Starr, MD, with heart valve replacement patient

Dr. Albert Starr with one of the first patients to receive an artificial heart valve

In 1960, Herbert Griswold, MD, the chief of cardiology at University of Oregon Hospital, learned of the durable function in dogs with a ball-in-cage mitral valve prosthesis. Griswold referred to Starr for valve replacement surgery a young woman near death from a severely damaged mitral valve. In August of 1960, Starr replaced her damaged mitral valve with a prosthesis Edwards had fabricated in his workshop. Her post-operative cardiac function was excellent, but she suddenly died 11 hours after surgery when air trapped in her enormously dilated left atrium embolized to her brain. This devastating outcome disheartened but did not discourage Starr and Edwards. Starr had learned a painful but vital technical lesson. Nonetheless, Starr and Edwards were encouraged by the valve’s performance. Four weeks later, Starr inserted a mitral valve prosthesis into a second patient. That man’s spectacular recovery and return to a normal life was dramatic proof that the prosthesis was effective and durable.

On March 21, 1961, Starr and Edwards presented the results of their first eight patients to the prestigious American Surgical Association. Five patients with terminal heart failure returned to normal lives after insertion of the Starr Edwards valve.  The manuscript published a few months later would be one of the top 100 medical manuscripts published in the 20th century:  

Mitral Replacement: Clinical Experience with a Ball-Valve Prosthesis. Starr A, Edwards ML. Ann Surg 1961; 154: 726-740.