The full content of Annals is available to subscribers

Subscribe/Learn More  >
Abstracts |

Phonocardiographic Diagnosis of Ball Variance in Aortic Valve Prostheses.

J. C. Hylen, M.D.; P. Q. Hull, M.D.; A. W. Ames, M.D.; F. E. Kloster, M.D.; and R. H. Herr, M.D.
Ann Intern Med. 1968;68(5):1156. doi:10.7326/0003-4819-68-5-1156_2
Text Size: A A A
This excerpt has been provided in the absence of an abstract.

Physical and chemical alterations in the silastic poppets of Starr-Edwards aortic valve prostheses or ball variance have been observed in over 15% of 270 patients. Swelling, grooving, eccentricity, and fragmentation can lead to acute malfunction and death if not corrected. Clinical diagnosis of ball variance has rested heavily on finding a loss, decrease, or varying intensity of the aortic opening sound by auscultation and phonocardiography, as most patients are asymptomatic. The present study established diagnostic criteria for ball variance to allow accurate antemortem diagnosis and early reoperation. Phonocardiograms (PCG) were recorded on 15 patients with ball variance subsequently verified at


First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.