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This study examines rare cardiac malformations in elderly patients, including subvalvular aortic stenosis and aneurysms of the membranous septum and Valsalva sinuses, presenting diagnostic challenges in determining congenital versus acquired origins.
Area of Science:
- Cardiovascular Pathology
- Congenital Heart Disease
- Acquired Cardiac Lesions
Context:
- Autopsy findings in elderly individuals (79-81 years old) revealed complex cardiac malformations.
- Distinguishing between congenital and acquired origins of these cardiac lesions proved challenging.
Purpose:
- To describe and analyze three distinct cases of cardiac malformations found at autopsy.
- To investigate the pathological characteristics and potential origins of these rare cardiac lesions.
Summary:
- Case 1: Band-shaped fibromuscular subvalvular aortic stenosis.
- Case 2: Isolated aneurysm of the membranous interventricular septum with a diverticulum, featuring tunnel-like projections into both atria and evidence of inflammation.
- Case 3: Aneurysms of the Valsalva sinuses.
Impact:
- Highlights the importance of detailed pathological examination in elderly patients with cardiac abnormalities.
- Contributes to the understanding of rare cardiac malformations and their differential diagnosis.
- Provides insights into the potential progression and complications of septal and valvular cardiac lesions.
Abstract:
In patients aged 79, 80 and 81 cardiac malformations were found at autopsy which did not permit to decide with certainty whether they were congenital or acquired. In the first case the lesions appeared as a band-shaped fibromuscular subvalvular aortic stenosis, the second one being an isolated aneurysm of the membranous septum directed to the righ side and combined with a minute diverticulum in the muscular part of the interventricular septum. The apex of the aneurysm faced the septal cusp of the tricuspid valve. From its dorsocranial circumference two tunnel-like formations projected in the dorsocranial direction terminating blindly beneath the atrial septal endocardium. The ventral canal protruded into the right, the dorsal one into the left atrium. Rather marked regressive changes and areas of florid chronic inflammation were found in the terminal parts of these channels. In the third case observed the pathological lesion were aneurysms of the Valsalva sinuses.