New observations on the etiology of aortic valve disease: A surgical pathologic study of 236 cases from 1990

Anthony J. Dare, John P. Veinot, William D. Edwards, Henry D. Tazelaar, Hartzell V Schaff

Research output: Contribution to journalArticle

114 Citations (Scopus)

Abstract

Among 236 aortic valves surgically excised at the Mayo Clinic in 1990 (mean patient age, 66 years; age range, 10 to 92 years), 154 (65%) were stenotic, 58 (25%) were insufficient, and 24 (10%) were both stenotic and insufficient. Pure stenosis was related to calcification, and causes included degenerative (51%), bicuspid (36%), postinflammatory (9%), and other (4%) reasons. Fourteen (9%) valves with pure stenosis also underwent ventricular septal myectomy, 12 for hypertrophy and two for co-existent hypertrophic cardiomyopathy. Pure insufficiency was not related to calcification, and causes included aortic root dilatation (50%), bicuspid valve (14%), postinflammatory (14%), posttherapeutic (14%), and other (8%) reasons. Combined stenosis and insufficiency was secondary to degenerative calcification (46%), bicuspid and postinflammatory etiologies (17% each), posttherapeutic (13%), and indeterminate (8%) causes. New observations include the following findings: (1) degenerative (senile) disease is the most common cause of aortic stenosis and combined stenosis and insufficiency at the Mayo Clinic, (2) aortic root dilatation is the most common cause of pure aortic insufficiency, (3) posttherapeutic aortic valve disease now leads to valve replacement in a substantial percentage of patients, particularly among those with insufficiency, (4) postinflammatory (presumably rheumatic) disease is relatively uncommon in all three functional categories, (5) septal myectomy may be performed for hypertrophic states other than hypertrophic cardiomyopathy, and (6) adults with operated congenital heart disease are undergoing valve replacement for annular dilatation with insufficiency. Because of the increasing age of the general population, the prominence of age-related degenerative aortic valve calcification and aortic root dilatation may have important implications concerning future health care costs.

Original languageEnglish (US)
Pages (from-to)1330-1338
Number of pages9
JournalHuman Pathology
Volume24
Issue number12
DOIs
StatePublished - 1993

Fingerprint

Aortic Diseases
Aortic Valve
Dilatation
Pathologic Constriction
Hypertrophic Cardiomyopathy
Bicuspid
Heart Valve Diseases
Aortic Valve Stenosis
Rheumatic Diseases
Mitral Valve
Health Care Costs
Hypertrophy
Population
Calcification of Aortic Valve

Keywords

  • aortic valve disease
  • geriatric disease
  • health care costs
  • surgical pathology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

New observations on the etiology of aortic valve disease : A surgical pathologic study of 236 cases from 1990. / Dare, Anthony J.; Veinot, John P.; Edwards, William D.; Tazelaar, Henry D.; Schaff, Hartzell V.

In: Human Pathology, Vol. 24, No. 12, 1993, p. 1330-1338.

Research output: Contribution to journalArticle

Dare, Anthony J. ; Veinot, John P. ; Edwards, William D. ; Tazelaar, Henry D. ; Schaff, Hartzell V. / New observations on the etiology of aortic valve disease : A surgical pathologic study of 236 cases from 1990. In: Human Pathology. 1993 ; Vol. 24, No. 12. pp. 1330-1338.
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