The congenital bicuspid aortic valve with post-inflammatory disease - A neglected pathological diagnosis of clinical relevance

It is unusual to find surgically excised congenital bicuspid aortic valves with post-inflammatory disease. We have analysed retrospectively all surgically excised aortic valves over a 6-year period for this particular diseased state in relation to relevant clinical data. There were 181 congenital bicuspid aortic valves and the characteristic gross pathology of the tricuspid aortic valve with post-inflammatory disease served as reference. Twelve of the 181 congenital bicuspid aortic valves were identified as post-inflammatory (6.6%); one with clinically established rheumatic disease. The mean age at operation of these 12 patients was significantly lower compared to 'other' aortic valves. The study indicates that post-inflammatory involvement of a congenital bicuspid aortic valve can be identified which is of clinical relevance since these patients have a significantly younger age at operation.