Ageing changes in human heart valves.

Abstract

With the increasing number of necropsies on elderly patients, knowledge of ageing changes is becoming important for assessment of pathological findings.Few studies on these changes in human heart valves exist.Gross and Kugel (1931), des- cribing the topographic anatomy and histology, briefly mention findings in the elderly, and more recently McMillan and Lev (1964) studied ageing in 200 human hearts.Their paper dealt mainly with early changes; 44 cases were under 1 year of age, none was over 85, and only 18 were over 70.The present communication is concerned with the changes at the other extreme of life, since is pre- dominantly in elderly patients that difficulties in interpreting the appearances of heart valves are likely to arise. MATERIAL AND METHODSOver a period of 27 months the hearts from all patients aged over 10 years coming to necropsy in this hospital were examined in detail before fixation.Particular attention was paid to the site and degree of valvular thickenings, atheromatous and calcific deposits, scarring and other focal lesions, fusion and fenestration of semilunar valves, and ballooning ofatrio-ventricular valves.Valves distorted by acute or chronic endocarditis were excluded from the present study.Atrio-ventricular valve thickening and mitral valve atheromatosis were graded as slight, moderate, or marked, by inspection and palpation.Findings were recorded on a punch card system, together with relevant clinical data.The hearts of all patients under 30 or over 80, and a representative group from each intermediate hemidecade, were fixed in formol saline, as were all cases with endo- cardial and valvular abnormalities, however minor.After 5-15 days' fixation, all were re-examined macroscopically, and material was selected for