Show simple item record

dc.contributor.authorTorre, Matthew
dc.contributor.authorHwang, David H.
dc.contributor.authorPadera, Robert F.
dc.contributor.authorMitchell, Richard N.
dc.contributor.authorVanderlaan, Paul
dc.date.accessioned2019-01-04T14:57:06Z
dc.date.issued2016-01
dc.identifier.citationTorre, Matthew, David H. Hwang, Robert F. Padera, Richard N. Mitchell, and Paul A. VanderLaan. 2016. “Osseous and Chondromatous Metaplasia in Calcific Aortic Valve Stenosis.” Cardiovascular Pathology 25 (1): 18–24. https://doi.org/10.1016/j.carpath.2015.08.008.en_US
dc.identifier.issn1054-8807en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37968244*
dc.description.abstractBackground: Aortic valve replacement for calcific aortic valve stenosis is one of the more common cardiac surgical procedures. However, the underlying pathophysiology of calcific aortic valve stenosis is poorly understood. We therefore investigated the histologic findings of aortic valves excised for calcific aortic valve stenosis and correlated these findings with their associated clinical features.Results and Methods: We performed a retrospective analysis on 6685 native aortic valves excised for calcific stenosis and 312 prosthetic tissue aortic valves with calcific degeneration at a single institution between 1987 and 2013. Patient demographics were correlated with valvular histologic features diagnosed on formalin-fixed, decalcified, and paraffin embedded hematoxylin and eosin stained sections. Of the analyzed aortic valves, 5200 (77.8%) were tricuspid, 1473 (22%) were bicuspid, 11 (0.2%) were unicuspid, and 1 was quadricuspid. The overall prevalence of osseous and/or chondromatous metaplasia was 15.6%. Compared to tricuspid valves, bicuspid valves had a higher prevalence of metaplasia (30.1% vs. 11.5%) and had an earlier mean age of excision (60.2 vs. 75.1 years old). In addition, the frequency of osseous metaplasia and/or chondromatous metaplasia increased with age at time of excision of bicuspid aortic valves, while tricuspid aortic valves showed the same incidence regardless of patient age. Males had a higher prevalence of metaplasia in both bicuspid (33.5% vs. 22.3%) and tricuspid (13.8% vs. 8.6%) aortic valves compared to females. Osseous metaplasia and/or chondromatous metaplasia was also more common in patients with bicuspid aortic valves and concurrent chronic kidney disease or atherosclerosis than in those without (33.6% vs. 28.3%). No osseous or chondromatous metaplasia was observed within the cusps of any of the prosthetic tissue valves.Conclusions: Osseous and chondromatous metaplasia are common findings in native aortic valves but do not occur in prosthetic tissue aortic valves. Bicuspid valves appear to have an inherent proclivity for metaplasia, as demonstrated by their higher rates of osseous metaplasia and/or chondromatous metaplasia both overall and at earlier age compared to tricuspid and prosthetic tissue aortic valves. This predilection could be due to aberrant hemodynamic forces on bicuspid valves, as well as intrinsic genetic changes associated with bicuspid valve formation. Aortic valve interstitial cells may play a central role in this process. Calcification of prosthetic tissue valves is most likely a primarily dystrophic phenomenon.en_US
dc.language.isoen_USen_US
dc.publisherElsevier BVen_US
dc.relation.hasversionhttp://www.cardiovascularpathology.com/article/S1054880715001088/pdfen_US
dash.licenseMETA_ONLY
dc.titleOsseous and Chondromatous Metaplasia in Calcific Aortic Valve Stenosisen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalCardiovascular Pathologyen_US
dash.depositing.authorVanderlaan, Paul
dc.date.available2019-01-04T14:57:06Z
dash.workflow.comments1Science Serial ID 19502en_US
dc.identifier.doi10.1016/j.carpath.2015.08.008
dc.source.journalCardiovascular Pathology
dash.source.volume25;1
dash.source.page18-24
dash.contributor.affiliatedVanderlaan, Paul


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record