Bone formation in cardiac valves: a histopathological study of 128 cases

Abstract

In a series of 1,177 patients with surgical valve resection, there were 128 (10.9%) patients with the histological finding of bone and/or cartilage formation (bony metaplasia; heterotopic ossification) in the excised valve (119 aortic, 9 mitral). The incidence was higher in men (12.8%) than in women (8.5%). The bony metaplasia was always associated with valvular calcification. The metaplastic changes were encountered in all types of calcific aortic valve disease (senile, bicuspid valve, post-rheumatic). The marrow of the heterotopic lamellar bone was mostly composed of adipose tissue. Frequently, it showed chronic inflammation with polyclonal plasmocytic infiltration. Complete haematopoiesis was present only rarely.

Identification and Characterization of Aortic Valve Mesenchymal Progenitor Cells with Robust Osteogenic Calcification Potential

“…For example, lamellar bone with osteoblasts and osteocytes is observed in 11% to 13% of calcified human aortic valves. 4,5 The marrow of this heterotopic bone contains adipose tissue. 4,5 Chondrocytes, cartilage, and endochondral ossification have been observed in both human and mouse aortic valves.…”

“…4,5 The marrow of this heterotopic bone contains adipose tissue. 4,5 Chondrocytes, cartilage, and endochondral ossification have been observed in both human and mouse aortic valves. 4,6 Late-stage diseased valves are frequently fibrotic with an abundance of myofibroblasts, often observed adjacent to calcified regions.…”

“…[22][23][24] Conversely, evidence of bone-related matrix proteins, 21,25,26 transcription factors, 26 and mineral 21 in VIC cultures suggests that calcification can occur in vitro via an osteogenic process, which is consistent with evidence in vivo. 4,5,27,28 However, even in VIC cultures that express bone markers, calcified nodules are reported to contain a core of dead cells, 21 which is not observed in bone nodules formed by osteoprogenitors harvested from established sources. 29 -31 Therefore, the osteogenic potential of VICs has not been established definitively, and the identity and frequency of the putative osteoprogenitor subpopulation are not defined.…”

Osseous Metaplasia in mitral valve in an elderly case

“…Bu çalışmada 79 yaşındaki kadın hastanın mitral kapak eksizyon materyalinde saptadığımız kalsifikasyona eşlik eden osseöz metaplaziyi sunmayı amaçladık. [3]. Bu nedenle vasküler yapılar-da ve kalp kapaklarında oluşan kalsifikasyonun ve ossifikasyonun inflamatuar bir durum olduğu kabul edilmektedir [9].…”

“…Bu nedenle vasküler yapılar-da ve kalp kapaklarında oluşan kalsifikasyonun ve ossifikasyonun inflamatuar bir durum olduğu kabul edilmektedir [9]. Kalp kapaklarında kemik oluşumu çoğunlukla kalsifikasyonla birliktedir [3]. Ossifiye kalp kapaklarındaki kemik hücrelerinin orjini bilinmemektedir.…”