1 From the Department of Radiology and the Department of Surgery (Cardiovascular Unit), Harvard Medical School and the Massachusetts General Hospital, Boston, Massachusetts.
Forty-nine patients whose clinical symptoms suggested a leaking cardiac prosthetic valve were studied by both cineradiography and angiocardiography. We found a wider range of tilting motion of the nonleaking mitral valve than has been previously shown. An angle of tilt greater than 6° for the prosthetic aortic valve strongly suggests separation of the prosthesis from its bed with a paravalvular leak, while the angle of tilt suggestive of a paravalvular leak for a prosthetic mitral valve is 12°. However, a tilt of less than these values does not entirely exclude the existence of a leak. We strongly suggest that routine cineradiography be done in each patient shortly after surgery, as a basis for comparison if the patient later develops a murmur or congestive heart failure.
Submitted on April 9, 1973
© 1973 American Heart Association, Inc.
Cineradiographic Evaluation of Prosthetic Cardiac Valves
Key Words: Aortic valve, prosthetic • Paravalvular leak • Mitral valve, prosthetic • Angiocardiography • Valvular tilt
Accepted on May 14, 1973
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  M. J. Sands Jr, C. N. Leach Jr, A. S. Lachman, and H. Levine Thrombosis of the Bjork-Shiley Aortic Valve Prosthesis: Recognition and Management JAMA, September 22, 1978; 240(13): 1411 - 1413. [Abstract] [PDF]
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