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25 - Heart: Chronic infective endocarditis

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Rodin Number: 10
E Number: none
Donor: Osler
Date: unknown
Size (H x W cm): 11 x 10

The specimen shows a bicuspid aortic valve with a prominent raphé (long arrow (A)) separating the fused right and left leaflets. Vegetations of infectious endocarditis are evident on both fused and unfused sides. Two perforations, one related to a small aneurysm, can be seen (short arrows).

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Comment

Osler's pathologic description of the case is given in Case V of the Montreal General Hospital Reports 1880, I: 328. Clinical details are absent because the notes were "mislaid"; however, he indicates that the 45 year-old man had "the usual symptoms of severe aortic valve disease". According to Osler, the valve was incompetent ("water pours through with great freedom"). His illustration and this specimen fit well with acute infectious endocarditis superimposed on a congenitally bicuspid valve.

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