Identify all the metallic structures in the radiograph
1. Sternotomy wires. 2. Cardiac pacemaker. 3. Aortic prosthetic valve. 4. Mitral prosthetic valve.
What is the type of cardiac prosthetic valve used in this patient?
Hancock pericardial heart valve. The base ring is narrow, circular, in a wire like form. The remainder of the valve is radiolucent and does not appear in the radiograph.
How can we distinguish an aortic valve prosthesis from a mitral valve?
In a frontal radiograph, a reference line may be drawn from the left atrial appendage to the right cardiophrenic recess. The aortic valve typically lies above this reference point and has the orifice pointing towards the left ventricular outlet/aortic root. Conversely the mitral valve is below this reference line with the orifice directed towards the left ventricle/cardiac apex. However this reference is subject to change based on the amount of cardiomegaly that inadvertently these patients have.
See the question and answers below.