Key result
Intermittent obstruction due to ball variance occurred in 9% of patients with the Cutter-Smeloff mitral prosthesis, compared to 0% with the Starr-Edwards prosthesis.
Why the study?
Does the Cutter-Smeloff mitral valve prosthesis have a higher risk of intermittent obstruction due to ball variance compared to the Starr-Edwards prosthesis?
Case Report (n=3)
Does the Cutter-Smeloff mitral valve prosthesis have a higher risk of intermittent obstruction due to ball variance compared to the Starr-Edwards prosthesis?
The Cutter-Smeloff mitral valve prosthesis is associated with a 9% incidence of intermittent obstruction due to ball variance, a complication not observed with the Starr-Edwards prosthesis.
Answers are grounded in this paper and cite their sources.
Variable pulse and sounds may indicate ball variance in Cutter-Smeloff mitral prostheses; case reports leave open incidence and management.
Three cases of intermittent obstruction of the mitral prosthesis (Cutter-Smeloff) due to ball variance have been reported. The typical findings were marked variation in the arterial pulse and the intensity of the mitral closing sound and intermittent absence of the opening click. The phonocardiography revealed varying intervals from aortic closing sound to the opening click (A 2 - OC interval). Hemodynamic studies revealed fluctuating aortic and pulmonary artery wedge pressures in spite of normal sinus rhythm, due to impaction of the ball into the prosthetic ring, opening only with severe elevation of the left atrial pressure. At operation, the balls showed yellowish discoloration, but no disruption of sutures nor thrombosis of the prosthesis was found. The incidence of this phenomenon was 9% with the Cutter-Smeloff mitral prosthesis, but no such case was seen among patients with the Starr-Edwards mitral prosthesis.
No takes yet. Share an insight, caveat, or question.
Lee et al. (1970) conducted a case report in Mitral valve prosthesis malfunction (n=3). Cutter-Smeloff mitral prosthesis vs. Starr-Edwards mitral prosthesis was evaluated on Intermittent obstruction due to ball variance. Intermittent obstruction due to ball variance occurred in 9% of patients with the Cutter-Smeloff mitral prosthesis, compared to 0% with the Starr-Edwards prosthesis.
Synapse has enriched 10 related papers. Consider them for comparative context: