Surgical Pathology of the Heart Valves. A Study of 872 Cases

Overview

In this study, 872 heart valves surgically excised from 810 patients during a period of 5 years(1994 through 1998) were examined pathologically.There was a predominance of aortic (506 patients) versus mitral valves (246 pts.). While aorticvalves came more often from men (364) than from women (142), in mitral valves the M:F ratio is82/164. Isolated calcific aortic stenosis appeared as the most frequent valvular disease (418 pts.),with predominance of its sclerotic - senile type (238 pts.). Mitral stenosis (185 pts.) remains theclassical postrheumatic disease. The relative frequency of a subvalvular stenosing mitral lesion isstressed. The „pure“ incompetence of both aortic (70 pts.) and mitral (56 pts.) valve was usuallybased on valvular myxoid degeneration. An aorto-mitral disease requiring replacement of bothvalves (51 pts.) presented typically as a postrheumatic lesion, however, a combination of a postr-heumatic mitral with a degenerative - sclerotic aortic valve disease may be possible. In 30 pati-ents, the valvular replacement was performed for infective endocarditis or a post-IE lesion,mostly of the aortic valve.With the almost non-existence of acute rheumatic fever and with the increasing average age ofpopulation in this country, we may expect a long-term decline in mitral valve disease and anincrease in aortic valve disease, particularly in the sclerotic type of aortic stenosis.

Key words:
surgically excised heart valves - valvular diseases - etiopathogenesis - aortic stenosis -myxoid degeneration