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Continuing disease process of calcific aortic stenosis. Role of microthrombi and turbulent flow

P D Stein, H N Sabbah, J V Pitha

    The American Journal of Cardiology
    |February 1, 1977
    PubMed

    Insights

    Microthrombi were found in over half of diseased aortic valves, suggesting their organization contributes to valve deformity and stenosis progression. Fluid dynamics may initiate these microthrombi, driving continuous aortic valve disease.

    Area of Science:

    • Cardiovascular Pathology
    • Biomedical Engineering

    Background:

    • Aortic valve stenosis (AVS) is a progressive condition.
    • The underlying mechanisms of AVS progression are not fully understood.

    Purpose of the Study:

    • To investigate the presence and role of microthrombi in calcified and stenotic aortic valves.
    • To explore the potential contribution of microthrombi to aortic valve deformity and stenosis progression.

    Main Methods:

    • Histopathological examination of 19 surgically excised calcified and stenotic aortic valves.
    • Microscopic analysis for evidence of microthrombi and their organization.

    Main Results:

    • Organized microthrombi were identified in 10 out of 19 (53%) examined aortic valves.
    • Evidence suggests that the organization of these microthrombi contributes to valve leaflet thickening and deformity.
    • A continuous cycle of microthrombi deposition, organization, and calcification may explain progressive stenosis.

    Conclusions:

    • Microthrombi are a significant finding in calcified and stenotic aortic valves.
    • The process of microthrombi organization appears to be a key factor in the progression of aortic valve stenosis.
    • Fluid dynamic factors, such as turbulent flow, may initiate microthrombi formation, highlighting a potential link between hemodynamics and valve pathology.

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