Hemodynamic significance of normal and abnormal fluoroscopic patterns of disc motion in the Beall mitral valve...

Thirty-eight patients with a Beall mitral valve prosthesis were studied by cinefluoroscopy and cardiac catheterization to determine which characteristic of disc morphology and which patterns of disc motion predict significant valve malfunction. Eleven patients with a Beall 105/106 prosthesis served as a control group. There were two normal patterns of disc motion: (a) disc moving either entirely parallel to the suture ring or (b) disc having an intermediate nonparallel position but normal systolic and diastolic seating. Twenty-seven patients had a Beall 104 prosthesis. Fourteen of these had normal disc motion, only one showing significant mitral insufficiency. Thirteen of the 27 patients had abnormal disc motion with systolic cocking of the disc; 12 of these had significant mitral insufficiency, and all 13 showed severe disc wear at surgery.