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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