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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
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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

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