J.Jpn. Surg. Soc.. 80(5): 412-423, 1979

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Original article

STUDIES ON THE CALCIFICATION OF THE MITRAL VALVES IN JAPANESE

Excised mitral valves in surgery of 60 cases of Japanese were studied by means of soft X-ray (35 kV. 100 mA) and microscope. The cases of mitral stenosis included those of prominent stenosis with slight regurgitation and the cases of mitral regurgitation included those of prominent regurgitation with slight stenosis.
The following results were obtained;
1. Calcification was recognized by soft X-ray in 19 cases out of 36 mitral stenosis (53%) and in 4 cases out of 24 mitral regurgitation (17%).
2. Main changes of the valves were fibrotic thickening at commissures extending to leaflets and chordae tendinae in both cases of stenosis and regurgitation.
3. Calcified valves were classified into 3 types by findings of soft X-ray ; Dotty type－spot like shadow－in 6 cases (32%), Linear type－slender bar like shadow－in 5 cases (26%) and Massive type－mass shadow－in 8 cases (42%).
4. Noncalcified valves in mitral stenosis were classified into three groups according to the location of remarkable fibrotic thickening ; Group I－located in commissures－in 7 cases (41%), Group II－extended from commissure to leaflet－in 9 cases (53％), Group III－located at leaflet－one case (6％).
Fusion of the chordae tendinae were observed 2 cases in group I and 4 cases in group II.
5. Noncalcified valves in mitral regurgitation were classified into three groups according to the lesions of the mitral complex ; Group α－located at leaflet－in 14 cases (71%), G roup β－extended from leaflet to chordae tendinae－in 6 cases (25%) and Group γ－located at chordae tendinae－in 1 case (4%).
6. In mitral regurgitation, there were 4 cases of calcified valves which belong to the dotty type.
7. Histological changes such as disorder of elastic fiber, vascularization and bleeding were more remarkable in mitral regurgitation rather than in mitral stenosis.

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