Morphology of the human cardiac valves of inflammatory and non-inflammatory genesis of the aquired heart defects

Abstract

Summary. The prosthetics of the heart valves was and remains one of the main parts of cardiac surgery. Reliable information about the nature of valve heart defects will be useful for developing the most effective treatment regimens for patients.

The aim of the study – to investigate morphological peculiarities of the heart valves, which were removed during the surgical replacement of their prostheses.

Materials and Methods. The material for the morphological study of the valves was taken in the Institute of Cardiovascular Surgery named after M. M. Amosov. There were studied the main structural components of 855 valves (377 mitral and 478 aortic ones). Out of the cusps, chordae and papillary muscles, according to the generally accepted method, there were made histological specimens, which were stained with hematoxylin-eosin, with picrofuchsin according to Van Gieson method, Weigert resorcin-fuchsin method and also according to MSB method in Zerbino-Lukasevich modification. Frozen sections were processed by means of Sudan to identify adipose cells.

Results. There was revealed the predominance of lesions of the aortic valve. The frequency of pathological processes causing acquired heart defects has been clarified. The analysis of structural changes revealed the predominance of lipoidosis in the group of non-inflammatory valve damage. When estimating the specific gravity of lipoidosis in 46.4 %, it was combined with rheumatism, infectious endocarditis, dysplasia, and myxomatous degeneration.

Conclusions. Morphological analysis of the surgical specimen showed that acquired heart defects are some polymorphic pathologies. In the foreground among the causes of defects there is rheumatic valvulitis (49.7 %), in the second place – non-inflammatory valve damage (38.4 %), in the third place – infective endocarditis (10.4 %). Acquired heart defects, caused by one of the above-mentioned reasons, are often complicated as a result of the layering of changes that are associated with hemodynamic trauma of the endocardium or lipoidosis. Cholesterol necrosis of the cusps is the basis for the development of infective endocarditis.