To the Editor.—
What follows is the report of a middle-aged man with a Marfan's syndrome in whom a Starr-Edwards prosthesis was inserted to replace an insufficient mitral valve. The case is reported because Marfan's syndrome usually afflicts the aortic valve, not the mitral, and because it illustrates why the mitral valve damaged by this disease should be replaced, not repaired.
Report of a Case.—
A 50-year-old man was admitted to the hospital on Jan 20, 1970, because of a six-month history of progressive exertional dyspnea, fatigue, and decreased exercise tolerance. Before these symptoms started, he worked actively as a machinist though he was known to have had a heart murmur for ten years.He stood 187.96 cm (6 ft 2 inches) tall, weighed 63 kg (139 lb), had long narrow fingers, a pigeon breast, lenticular ectopia, and a high arching palate. His blood pressure was 117/80 mm Hg and