PATHOLOGY OF AORTIC-VALVE STENOSIS AND PURE AORTIC REGURGITATION - A CLINICAL MORPHOLOGIC ASSESSMENT .2.

This two-part article examines the histologic and morphologic basis fo r stenotic and purely regurgitant aortic valves. Part I discussed sten otic aortic valves and Part II discusses causes of purely regurgitant aortic valves. In over 95% of stenotic aortic valves, the etiology is one of three types: congenital (primarily bicuspid), degenerative, and rheumatic. Other rare causes included active infective endocarditis, homozygous type II hyperlipoproteinemia, and systemic lupus erythemato sis. The causes of pure aortic regurgitation are multiple but can be s eparated into diseases affecting the valve (normal aorta) (infective e ndocarditis, congenital bicuspid, rheumatic, floppy), diseases affecti ng the walls of aorta (normal valve) (syphilis, Marfan's, dissection), disease affecting both aorta and valve (abnormal aorta, abnormal valv e) (ankylosing spondylitis), and disease affecting neither aorta nor v alve (normal aorta, normal valve) (ventricular septal defect, systemic hypertension). Diseases affecting the aortic valve alone are the most common subgroup of conditions producing purely regurgitant aortic val ves.