Author/Authors :
Ian C. Gilchrist، نويسنده , , John F. Cardella، نويسنده , , Preston S. Fox، نويسنده , , Walter E. Pae، نويسنده , , Ahmed A. El Ghamry Sabe، نويسنده , , J.Richard Landis، نويسنده , , A.Russell Localio، نويسنده , , Allen R. Kunselman، نويسنده , , Kenneth D. Hopper and From the Departments of Medicine Radiology، نويسنده , , Cardiothoracic Surgery، نويسنده , , and the Center for Biostatistics & Epidemiology، نويسنده , , The Pennsylvania State University College of Medicine and The Milton S. Hershey Medical Center.، نويسنده ,
Abstract :
Cineradiography can identify patients with single-leg fractured Björk-Shiley Convexo-Concave valves, although little is known about the sensitivity and specificity of this technique. We evaluated three normal and six (0 μm gap) single-leg fractured Björk-Shiley valves that were placed in a working phantom model. Valves were randomly imaged a total of 33 times and duplicated into a 120-valve series with a 1:9 ratio of abnormal/normal valves. Six reviewers independently graded each valve and demonstrated markedly different rates of identifying the fractured valves. Average sensitivity at the grade that clinically results in valve explanation was 47%. Among the normal valves, a correct identification was made 96% (range 91% to 99%) of the time. Present radiographic technology may have significant difficulty in identifying true single-leg fracture in Björk-Shiley valves with limb separations that are common among clinically explanted valves. (Am Heart J 1997;133:197-202.)
