title: Radiographic detection of single-leg fracture in Björk-Shiley Convexo-Concave prosthetic valves: a phantom model study.
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 microm 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.
authors.affiliation: Department of Medicine, The Pennsylvania State University College of Medicine, The Milton S. Hershey Medical Center, Hershey 17033, USA.
authors.forename: I C
authors.initials: IC
authors.lastname: Gilchrist
authors.forename: J F
authors.initials: JF
authors.lastname: Cardella
authors.forename: P S
authors.initials: PS
authors.lastname: Fox
authors.forename: W E
authors.initials: WE
authors.lastname: Pae
authors.forename: A A
authors.initials: AA
authors.lastname: el-Ghamry Sabe
authors.forename: J R
authors.initials: JR
authors.lastname: Landis
authors.forename: A R
authors.initials: AR
authors.lastname: Localio
authors.forename: A R
authors.initials: AR
authors.lastname: Kunselman
authors.forename: K D
authors.initials: KD
authors.lastname: Hopper
mesh_terms: D000790:Angiocardiography / Q000295:instrumentation; D002933:Cineradiography; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging; D015588:Observer Variation; D019047:Phantoms, Imaging; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012680:Sensitivity and Specificity