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November 7, 1977

Poppet Embolization From Braunwald-Cutter Aortic Valve

JAMA. 1977;238(19):2057. doi:10.1001/jama.1977.03280200069027

RECENTLY, McGoon pointed out the limitations of the prostheses available for aortic valve replacement.1 Although the majority of prosthetic valves available are durable and hemodynamically acceptable, the threat of thromboembolism has continued to exist.

Disk variance has been reported to occur in various models of disk prostheses. Recently, our service reported four cases of disk thinning, grooving, and notching in Beall mitral valve prostheses.2 Those changes resulted in migration of the disk in one case. It was pointed out that the awareness of the various manifestations of disk variance is essential for the care of patients after prosthetic valve replacement.

Although ball-valve variance in the original Starr-Edwards aortic valve was well recognized, Silastic ball embolization has been reported rarely. In 1971, the Braunwald-Cutter clothcovered prosthesis with a Silastic poppet became available for clinical use.3 In 1974, Pluth and Danielson4 reported two cases of poppet escape that