Surgical pathology of aortic valve disease *1A study based on 602 specimens

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Abstract
A consecutive series of 602 surgically excised aortic valves wasevaluated by means of macroscopic and histological study. Pure aorticstenosis was diagnosed in 140 patients, pure incompetence in 254 andcombined dysfunction in 208. Of the cases with pure aortic stenosis, 38%were rheumatic, 34% were calcified bicuspid valves and 23% showeddystrophic calcification. Half the patients with pure aortic regurgitationshowed aortic root dilatation. Most cases of combined aortic stenosis andregurgitation were the sequelae of rheumatic fever. A male prevalence wasdetectable in each group (mean male: female ratio = 2.6), and was highestin infective endocarditis and aortic root dilatation. Infectiveendocarditis was a frequent complication of congenitally bicuspid valves.In conclusion, rheumatic disease is still a frequent cause for surgicalreplacement of the aortic valve. At least half the explanted aortic valveshave degenerative or congenital diseases which are often the site of asuperimposed infective endocarditis.

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