title: Morphological and chemical study of pathological deposits in human aortic and mitral valve stenosis: a biomineralogical contribution.
abstract: Aim of this study was to investigate heart valve calcification process by different biomineralogical techniques to provide morphological and chemical features of the ectopic deposit extracted from patients with severe mitral and aortic valve stenosis, to better evaluate this pathological process. Polarized light microscopy and scanning electron microscopy analyses brought to light the presence of nodular and massive mineralization forms characterized by different levels of calcification, as well as the presence of submicrometric calcified globular cluster, micrometric cavities containing disorganized tissue structures, and submillimeter pockets formed by organic fibers very similar to amyloid formations. Electron microprobe analyses showed variable concentrations of Ca and P within each deposit and the highest content of Ca and P within calcified tricuspid aortic valves, while powder X-ray diffraction analyses indicated in the nanometer range the dimension of the pathological bioapatite crystals. These findings indicated the presence of highly heterogeneous deposits within heart valve tissues and suggested a progressive maturation process with continuous changes in the composition of the valvular tissue, similar to the multistep formation process of bone tissue. Moreover the micrometric cavities represent structural stages of the valve tissue that immediately precedes the formation of heavily mineralized deposits such as bone-like nodules.
authors: Department of Earth Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
authors: Valentina
authors: V
authors: Cottignoli
authors: Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy.
authors: Elena
authors: 0000-0003-0221-6000
authors: E
authors: Cavarretta
authors: Division of Cardiac Surgery, San Bortolo Hospital, Viale Rodolfi 37, 36100 Vicenza, Italy.
authors: Loris
authors: L
authors: Salvador
authors: Division of Cardiac Surgery, San Bortolo Hospital, Viale Rodolfi 37, 36100 Vicenza, Italy.
authors: Carlo
authors: C
authors: Valfré
authors: Department of Earth Sciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
authors: Adriana
authors: 0000-0002-2357-247X
authors: A
authors: Maras