Aschoff bodies in left auricular appendages of patients with mitral stenosis; clinicopathologic study, including postoperative follow-up.

Abstract

IN RECENT years surgical valvulotomy for mitral stenosis has made it possible to examine microscopically the left auricular appendage and observe histologically the rheumatic process in a part of the heart during life. Since this is a phase in the natural history of rheumatic fever, it may be possible to correlate the incidence and degree of activity with the clinical events of rheumatic cardiac disease. Although the lesions of rheumatic fever have been described in the left auricle proper,* the auricular appendage has escaped more critical examination. Von Glahn, 8 in a study of rheumatic auricular endocarditis, concluded that the changes observed may extend into the first portion of the auricular appendage. He did not, however, record Aschoff bodies in this location. Similarly, Gross, 9 in an exhaustive review of rheumatic auricular lesions, made no reference to the auricular appendage. Unusual circumstances have on occasion prompted the making of sections of this