Radiographic Diagnosis of Aortic-Ball Variance

Assessing changes in the silicone-rubber ball of the Model 1000 series Starr-Edwards aortic-valve prosthesis is an increasingly frequent diagnostic problem. Bariumimpregnated, silicone-rubber balls have been available since 1962. Presently, these constitute slightly less than 10% of all silicon-rubber balls distributed. Radiographic evidence of aortic-ball variance was obtained for a patient having normal sounds of the prosthetic aortic valve as determined by auscultation, phonocardiography, and sound spectrography. All silicone-rubber balls now produced by the manufacturer are barium-impregnated; henceforth, radiographic techniques will be more uniformly applicable to the early diagnosis of aortic-ball variance. Since most patients with aortic-ball variance are asymptomatic, routine screening for the early detection of ball variance is suggested for all patients with barium-impregnated, silicone-rubber balls. Serial high-resolution films and cineradiography should be used.