Name That Valve

These six cases show various artificial heart valves on chest radiography, with indications of how to determine what valve has been replaced.

The analysis depends primarily on

(1) LOCATION of the valve (using a diagonal line on the lateral view to separate aortic and mitral regions)

(2) ORIENTATION of the valve on two orthogonal radiographic views.

Observation of whether the valve is seen 'en face' or 'edge-on' (ORIENTATION) will determine the direction blood must be flowing across the valve. Some valves are made of metal, which makes this easier to determine. Some are made of plastic or natural tissues, which are hard to see on x-ray.

Each case shows the steps in analysis before revealing the answer.