Abundant dystrophic calcifications mimicking aortic valve abscess in a patient undergoing elective aortic valve replacement

Adam L. Booth, Christine Q. Li, Ghannam Al-Dossari, Heather Stevenson-Lerner

Research output: Contribution to journalArticle

Abstract

Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation. Aortic valve leaflets and necrotic-appearing thymic lymph node tissue were submitted for histology and special stains. Cultures were negative and histology did not show evidence of infection. Tissue histology demonstrated extensive dystrophic calcifications, which were polarised to reveal abundant calcium oxalate crystals. The benign nature of this unique pathological finding ruled out any suspicion of infection, avoiding a prolonged course of intravenous antibiotics in this patient.

Original languageEnglish (US)
Article number220368
JournalBMJ Case Reports
Volume2017
DOIs
StatePublished - 2017

Keywords

  • Cardiothoracic Surgery
  • Cardiovascular Medicine
  • Pathology
  • Valvar Diseases

ASJC Scopus subject areas

  • Medicine(all)

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