This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by HYLEN, J. C. Articles by GRISWOLD, H. E. Search for Related Content PubMed PubMed Citation Articles by HYLEN, J. C. Articles by GRISWOLD, H. E.

(Circulation. 1969;39:849.)
© 1969 American Heart Association, Inc.

---

Sound Spectrographic Diagnosis of Aortic Ball Variance

JOHN C. HYLEN M.D.¹; FRANK E. KLOSTER M.D.¹; RODNEY H. HERR M.D.¹; ALBERT STARR M.D.¹; HERBERT E. GRISWOLD M.D.¹

¹ From the Division of Cardiology, Department of Medicine, and the Division of Cardiopulmonary Surgery, Department of Surgery, University of Oregon Medical School, Portland, Oregon.

Abnormalities in the silastic poppets of cardiac valve prostheses have been detected with increasing frequency. Ball variance can cause serious mechanical dysfunction of the prosthesis and can result in sudden death. Contour sound spectrograms were recorded on 12 patients with ball variance confirmed by operation and 25 controls. In ball variance the frequency of the aortic opening sound at the second right intercostal space was decreased, with the peak frequency recorded being below 1,300 cycles/sec in 11 of the 12 patients. The peak frequency was greater than 1,300 cycles/sec in 24 of the 25 control patients. The remaining patient had peak frequencies in both the normal and abnormal range. The diagnosis of aortic ball variance in patients with triple valve replacement remains difficult because of the nearly synchronous tricuspid closing and aortic opening sounds. The sound spectrographic findings have been the most reliable objective evidence of ball variance in patients with Starr-Edwards aortic prostheses of the Model 1000 series.

Key Words: Silastic poppet • Starr-Edwards aortic prosthesis • Silicone rubber • Aortic opening sound • Aortic valvular dysfunction • Triple valve replacement • Contour sound spectrogram • Heart sounds

This article has been cited by other articles:

				J.J. Dow, T. D. Plemons, K. Scarbrough, H. Reeder, M. Hovenga, D. W. Wieting, and J. G. Chandler Acoustic Assessment of the Physical Integrity of Bjork-Shiley Convexo-Concave Heart Valves Circulation, February 18, 1997; 95(4): 905 - 909. [Abstract] [Full Text]

				H. R. Schelbert and O. F. Muller Detection of Fungal Vegetations Involving a Starr-Edwards Mitral Prosthesis by Means of Ultrasound Vascular and Endovascular Surgery, January 1, 1972; 6(1): 20 - 25. [PDF]