Native valves

Most are received in fragments though some may be submitted intact.

• identify and document the type of valve - aortic, congenital bicuspid aortic, mitral, tricuspid.

• photograph if intact.

• X-ray to document calcification.

• measure the dimensions (cm) of the valve and the valve orifice.

• describe the leaflets or cusps

- number, sizes (mm), consistency,

- abnormalities, e.g., myxoid changes, fibrosis, calcifications, thrombi, perforations.

• describe vegetations if present - distribution, location, consistency, presence of destruction of the valve leaflet or cusp.

• describe the commissures - relationship to each other - fused or not, completely or partially.

• describe the chordae tendinae - length, status - normal/shortened/thickened/stretched/ fused/ruptured.

• describe the papillary muscles - hypertrophy, elongation, scarring - evidence of recent or past myocardial infarction.

• decalcification may be needed.

Blocks for histology:

• representative sections are taken from the free edge of the valve to the annulus.

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