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William C. Roberts, MD; Gilbert E. Levinson, MD; Andrew G. Morrow, MD

Arch Intern Med. 1970;126(3):517-521.

Abstract
Lethal degeneration of a silicone rubber ball of a Starr-Edwards mitral prosthesis implanted for 78 months occurred. Variance of mitral silicone rubber poppets requires longer periods of implantation than required for degeneration of aortic poppets. Syncope or near syncope and congestive cardiac-failure appearing more than four years after mitral replacement with a silicone rubber poppet suggests ball variance. Alterations in intensity of the opening sound of the mitral prosthesis in the absence of arrhythmias further suggests this diagnosis.

Author Affiliations
Bethesda, Md

From the Section of Pathology and the Clinic of Surgery, National Heart and Lung Institute, Bethesda, Md, and the Division of Cardiovascu-; lar Diseases, Department of Medicine, New Jersey College of Medicine and Dentistry, Newark.

Footnotes
Received for publication April 3, 1970; accepted May 20.

Reprint requests to Section of Pathology, National Heart and Lung Institute, Bethesda, Md 20014 (Dr. Roberts).

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