Abstract
Significant valvular heart disease left untreated can have serious life-threatening consequences and given the lack of effective medical therapies and the evolution of valve-related devices, cardiac valve replacement and repair procedures are now performed frequently. Patients with heart valve disease gain significant survival and quality-of-life improvements with valve replacement. This chapter summarizes the pathologic anatomy and clinicopathological considerations in valve replacement and repair surgery, encompassing pathology associated with substitute valves and their repair as well as other pertinent cardiac and noncardiac pathology. It provides the reader with a broad overview and approach to the analysis of different prosthetic heart valves that may be encountered as surgical pathology or autopsy specimens (and potentially in a research setting). Discussion of the following related areas provides additional context: (1) surgical considerations and outcomes, (2) description of valve replacement devices, (3) approach to evaluating postsurgical hearts and substitute valves as pathological specimens, (4) transcatheter valve implantation, and (5) ongoing research and development. Attention is also given to pathologic considerations related to minimally invasive and repair procedures on cardiac valves.
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