Cusp disruption by massive lipid infiltration. A rare cause of porcine valve dysfunction

E. Arbustini, U. Bortolotti, M. Valente, A. Milano, V. Gallucci, N. Pennelli, G. Thiene

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Abstract

A 68-year-old man underwent reoperation because of severe incompetence of a mitral valve xenograft, 96 months following implantation. Gross examination of the device showed yellow spots on the cusps, suggesting lipid infiltration, and a torn commissure. Plasmatic cholesterol and lipoprotein levels were normal, X-ray examination of the explants showed no calcific deposits. Histologic and electron microscopic studies disclosed massive accumulation of lipid clefts and droplets, predominantly at the level of the tear; focal loss and detachment of the endothelial lining and scanty porcine fibroblasts and collagen bundles with preserved periodicity were also noted. Primary disruption of porcine valvular bioprostheses without significant calcifications or collagen breakdown is uncommon. In the present case, lipid accumulation was the main determinant of tissue failure.

Original languageEnglish
Pages (from-to)738-743
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume84
Issue number5
Publication statusPublished - 1982

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Arbustini, E., Bortolotti, U., Valente, M., Milano, A., Gallucci, V., Pennelli, N., & Thiene, G. (1982). Cusp disruption by massive lipid infiltration. A rare cause of porcine valve dysfunction. Journal of Thoracic and Cardiovascular Surgery, 84(5), 738-743.