Abbott Specimen 4
Specimen Card Nomenclature
Congenitally bicuspid aortic valve with spontaneous rupture of wall of ascending aorta and dissecting aneurysm
International Classification of Diseases
Bicuspid aortic valve with ascending aortic aneurysm and dissection
Atlas Illustration
None
Donor
Dr. Martin
Date
1907
Age
Unknown
Description
The specimen shows a hypertrophied and dilated left ventricle. There are two aortic valve leaflets, one of which shows nodular calcification (long arrow). Red rods are present in the left (L) and right (R) coronary artery orifices (the latter abnormally high). There is an ill-defined tear in the aorta which is continuous above with a rupture (short arrow).
Comment
The specimen probably originated in St Bartholomew’s Hospital London and was donated by Dr Martin to Abbott after the McGill medical building fire of 1907.
An origin of the right coronary artery above the sinus of Valsalva is sometimes seen in association with a bicuspid aortic valve. It is thought to be functionally insignificant in almost all cases. Ascending aortic dilatation (aneurysm formation) is common in patients who have a bicuspid aortic valve. Post-stenotic dilatation secondary to blood flow turbulence is likely an important pathogenetic factor in some cases. However, dilatation can be seen in the absence of stenosis, and it has been suggested that an abnormality of aortic wall connective tissue may also be involved.
