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- W2004157183 abstract "A 45-year-old veteran underwent closed mitral commissurotomies in 1957 and 1962. I n April, 1964, his mitral valve was replaced by a 0.900-inch SCDK double-caged prosthesis. Because of repeated thromboembolic episodes over the next three years and the recurrence of exertional dyspnea, orthopnea, and chest pains, he was referred to the Veterans Administration Hospital in May, 1967. He was in moderate congestive heart failure. At initial auscultation the cardiac rhythm was thought to be a sinus mechanism with multiple premature ventricular contractions; however, the peripheral pulses remained perfectly regular. There were changes in the intensity and timing of the opening and closing clicks of the prosthesis. The “auscultatory arrhythmia,” identified as a varying interval from the aortic closure to the opening click of the prosthesis (A,-O.C. interval), was documented by phonocardiography with simultaneously recorded arterial wave forms (Fig. 1). The A,2-0.C. interval varied from 0.10 to 0.62 second; at the longer intervals the opening click followed atrial contraction. At operation in May, 1967, granulating tissues obscured much of the metallic inflow face of the SCDK prosthesis, which was resected (Fig. 2) and replaced with a size 2M Starr-Edwards prosthesis. The Silastic ball of the resected prosthesis was opaque, light canary-yellow, and somewhat softer than a normal Silastic ball. T h e equatorial diameter of 0.922 inch caused it to “stick” in the 0.909-inch orifice of the prosthesis and prevented its travel to the atrial cage. Chemical analysis of the ball showed cholesterol and triglyceride deposits. T h e patient’s postoperative course was uneventful. Improvement of symptoms has been maintained to the present." @default.
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- W2004157183 date "1968-11-01" @default.
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- W2004157183 title "The Clinical Diagnosis of Ball Variance in a Mitral Valve Prosthesis" @default.
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- W2004157183 doi "https://doi.org/10.1016/s0003-4975(10)66058-4" @default.
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