Internal changes of the ball in De Bakey's valve prosthesis. Technical note
Rollin, B.; Mathieu, P.; Bénichoux, R.
Archives des Maladies du Coeur et des Vaisseaux 68(9): 939-940
1975
ISSN/ISBN: 0003-9683 PMID: 813595 Document Number: 95468
The DeBakey prosthetic ball valve contains a pyrolite ball in a metal cage. To facilitate postoperative surveillance, the internal wall of the ball, which is radiotransparent, is covered with a roughcast, nonhomogeneous radio-opaque layer, yielding an irregular outline in the radiogram. The adherence of the radio-opaque covering of the ball appears to be rather fragile since, only after a few mo. of service in the surgically treated heart, in the aortic position, it becomes detached and collects inside the radiotransparent ball in the form of a very dense conglomerate which behaves cineradiologically as a small, very mobile bell during every moment of the ball. Examination of 1 of these prostheses, surgically recovered 8 mo. after placement shows that the outside of the ball is perfectly normal but the inside contains a little pulverulent bell that makes a distinct noise when the ball is shaken. This probably explains the very distinct auscultatory sound of the prosthesis when in place before the re-operation. The question arises whether the shifting bell may not throw the ball out of balance, because of the instability of its center of gravity, and cause premature wear of the prosthesis.