Over the years the Starr Edwards prosthesis has demonstrated a high durability and improved survival in patients with severe aortic stenosis or insufficiency. While the ideal valve prosthesis is not yet available, the Starr-Edwards valve in most instances demonstrates an adequate hemodynamic performance, does not degenerate throughout the human life span, is biocompatible, and is inserted reliably without requiring unique technical dexterity. Despite occasional valve-related complications with early models, beneficial effects of valve replacement are clearly seen in patients with a reversible myocardial dysfunction, a lower level New York Heart Association functional class (II to III), and who survive the early postoperative period and the first year. Long-term complications seen with the Starr-Edwards valve are primarily thromboembolism, endocarditis, hemolysis, and anticoagulation related complications. Despite good operative results, the major cause of deaths in these patients remains cardiac.