Surgical pathology of pure aortic stenosis: A study of 374 cases

R. Subramanian, L. J. Olson, W. D. Edwards

Research output: Contribution to journalArticle

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Abstract

The gross surgical pathologic features of the aortic valve were reviewed in 374 patients who had had clinically pure aortic stenosis and aortic valve replacement at our institution during the years 1965, 1970, 1975, and 1980. The most common cause of aortic stenosis, accounting for 46% of our cases, was calcification of a congenitally bicuspid valve. In the remainder, stenosis was produced by postinflammatory fibrocalcific disease (including rheumatic disease) in 35%, by degenerative calcification of an aging valve in 10, and by calcification of a congenitally unicommissural valve in 6%. The cause of aortic stenosis was indeterminate in 4%. Valvular lesions included various degrees of dystrophic calcification, commissural fusion, and cuspid fibrosis. Calcification tended to occur more extensively and at a younger age in men than in women. Furthermore, it tended to produce stenosis and to necessitate valve replacement earliest in patients with unicommissural valves (mean age, 48 years), later in those with bicuspid or postinflammatory valves (mean age, 59 and 60 years, respectively), and latest in those with degenerative stenosis (mean age, 72 years). In our study, the relative incidence of postinflammatory aortic stenosis remained unchanged from 1965 to 1980, despite the steadily decreasing incidence of acute rheumatic fever reported in western countries. Our data suggest that (1) many episodes of acute rheumatic fever may be subclinical, or (3) some forms of nonrheumatic aortic valve disease may produce gross alterations indistinguishable from those of classic chronic rheumatic valvulitis.

Original languageEnglish (US)
Pages (from-to)683-690
Number of pages8
JournalMayo Clinic Proceedings
Volume59
Issue number10
StatePublished - 1984

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Surgical Pathology
Aortic Valve Stenosis
Aortic Valve
Pathologic Constriction
Rheumatic Fever
Cuspid
Aortic Diseases
Bicuspid
Incidence
Rheumatic Diseases
Mitral Valve
Fibrosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Subramanian, R., Olson, L. J., & Edwards, W. D. (1984). Surgical pathology of pure aortic stenosis: A study of 374 cases. Mayo Clinic Proceedings, 59(10), 683-690.

Surgical pathology of pure aortic stenosis : A study of 374 cases. / Subramanian, R.; Olson, L. J.; Edwards, W. D.

In: Mayo Clinic Proceedings, Vol. 59, No. 10, 1984, p. 683-690.

Research output: Contribution to journalArticle

Subramanian, R, Olson, LJ & Edwards, WD 1984, 'Surgical pathology of pure aortic stenosis: A study of 374 cases', Mayo Clinic Proceedings, vol. 59, no. 10, pp. 683-690.
Subramanian R, Olson LJ, Edwards WD. Surgical pathology of pure aortic stenosis: A study of 374 cases. Mayo Clinic Proceedings. 1984;59(10):683-690.
Subramanian, R. ; Olson, L. J. ; Edwards, W. D. / Surgical pathology of pure aortic stenosis : A study of 374 cases. In: Mayo Clinic Proceedings. 1984 ; Vol. 59, No. 10. pp. 683-690.
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