[Phonocardiographic characteristics of normally functioning Lillihei-Kaster mitral prostheses. Study of 61 cases...

A phonomechanocardiographic investigation has been carried out on 61 patients who had undergone mitral valve replacement with a Lillehei-Kaster prosthesis between May 1972 and April 1976 (Follow-up 48-96 months). All prostheses were considered to be well functioning according to clinical, electrocardiographic, radiological and laboratory findings. Based on the results of the present study the phonomechanocardiographic features of normal functioning Lillehei-Kaster mitral prostheses are the following: 1) a double or triple closing sound; 2) a small single or double opening sound recorded in 67.21% of our series. The opening sound, preceding the 0 point of the apexcardiogram of approximately 29.8 msec is most likely related to the beginning of the motion of the disc, whereas the opening sound coincident with or following the 0 point of the apexcardiogram is produced at the end of the opening movement of the disc; 3) the presence of meso or telediastolic clicks in patients with atrial fibrillation during longer diastolic periods or occasionally in patients with sinus rhythm, mild aortic regurgitation and or 1st. degree A-V block; 4) an apical diastolic rumble present in 68.85% of our cases, regardless of the size of the prosthesis, which does not necessarily indicate a prosthesis malfunction; 5) a systolic ejection murmur, recorded on the left upper sternal border in all our patients, is probably related to the turbulent blood flow around the prosthetic prongs which protrude into the left ventricular outflow tract.