Baylor University Medical Center Proceedings October 2017 - 436

41-year-old man with a "congenitally
malformed" stenotic aortic valve and
a stenotic mitral valve that appeared
to be of rheumatic origin.
On occasion, in patients with
rheumatic mitral stenosis, the aortic
valve may have fusion of one of its
three commissures, simulating a congenitally bicuspid aortic valve. In these
circumstances, however, the ventricular aspect of the fusion appears as a
V-shaped indention, producing some
space below the fusion. In contrast,
with a congenitally bicuspid aortic
valve, the ventricular aspect of the raphe area, which some may interpret as
fusion of the two cusps, is flat, such
that there is no space beneath the fusion. Such was the case in each of the
five patients described herein, indicating that the aortic valve in each was
congenitally malformed and not the
result of rheumatic heart disease.

b

a

c

d

Figure 1. Case 1. Mitral valve as viewed from the (a) ventricular aspect and (b) atrial aspect. Aortic valve as viewed
from the (c) aortic aspect and (d) ventricular aspect.

a

b

1. Theleman KP, Grayburn PA, Roberts WC.
Mitral "annular" calcium forming a complete circle "O" causing mitral stenosis in
association with a stenotic congenitally
bicuspid aortic valve and severe coronary artery disease. Am J Geriatr Cardiol
2006;15(1):58-61.
2. McReynolds RA, Ali N, Cuadra M,
Roberts WC. Combined acute rheumatic
fever and congenitally bicuspid aortic
valve: a hitherto unconfirmed combination. Chest 1976;70(1):98-100.
3. Tejada JG, Albarran A, Hernandez F,
Jimenez S, Tascon JC. Anomalous coronary artery origin associated with bicuspid
aortic valve in a patient with rheumatic
mitral stenosis: a case report. Angiology
2001;52(9):649-652.
4. Muthiah R. Rheumatic aortic valve disease
with mitral stenosis-a case report. J Clin
Med Case Rep 2016;5(8):268-295.

Figure 2. Case 2. (a) Thickened mitral valve and (b) bicuspid aortic valve.

436

Baylor University Medical Center Proceedings

Volume 30, Number 4



Table of Contents for the Digital Edition of Baylor University Medical Center Proceedings October 2017

No label
Baylor University Medical Center Proceedings October 2017 - No label
Baylor University Medical Center Proceedings October 2017 - Cover2
Baylor University Medical Center Proceedings October 2017 - 393
Baylor University Medical Center Proceedings October 2017 - 394
Baylor University Medical Center Proceedings October 2017 - 395
Baylor University Medical Center Proceedings October 2017 - 396
Baylor University Medical Center Proceedings October 2017 - 397
Baylor University Medical Center Proceedings October 2017 - 398
Baylor University Medical Center Proceedings October 2017 - 399
Baylor University Medical Center Proceedings October 2017 - 400
Baylor University Medical Center Proceedings October 2017 - 401
Baylor University Medical Center Proceedings October 2017 - 402
Baylor University Medical Center Proceedings October 2017 - 403
Baylor University Medical Center Proceedings October 2017 - 404
Baylor University Medical Center Proceedings October 2017 - 405
Baylor University Medical Center Proceedings October 2017 - 406
Baylor University Medical Center Proceedings October 2017 - 407
Baylor University Medical Center Proceedings October 2017 - 408
Baylor University Medical Center Proceedings October 2017 - 409
Baylor University Medical Center Proceedings October 2017 - 410
Baylor University Medical Center Proceedings October 2017 - 411
Baylor University Medical Center Proceedings October 2017 - 412
Baylor University Medical Center Proceedings October 2017 - 413
Baylor University Medical Center Proceedings October 2017 - 414
Baylor University Medical Center Proceedings October 2017 - 415
Baylor University Medical Center Proceedings October 2017 - 416
Baylor University Medical Center Proceedings October 2017 - 417
Baylor University Medical Center Proceedings October 2017 - 418
Baylor University Medical Center Proceedings October 2017 - 419
Baylor University Medical Center Proceedings October 2017 - 420
Baylor University Medical Center Proceedings October 2017 - 421
Baylor University Medical Center Proceedings October 2017 - 422
Baylor University Medical Center Proceedings October 2017 - 423
Baylor University Medical Center Proceedings October 2017 - 424
Baylor University Medical Center Proceedings October 2017 - 425
Baylor University Medical Center Proceedings October 2017 - 426
Baylor University Medical Center Proceedings October 2017 - 427
Baylor University Medical Center Proceedings October 2017 - 428
Baylor University Medical Center Proceedings October 2017 - 429
Baylor University Medical Center Proceedings October 2017 - 430
Baylor University Medical Center Proceedings October 2017 - 431
Baylor University Medical Center Proceedings October 2017 - 432
Baylor University Medical Center Proceedings October 2017 - 433
Baylor University Medical Center Proceedings October 2017 - 434
Baylor University Medical Center Proceedings October 2017 - 435
Baylor University Medical Center Proceedings October 2017 - 436
Baylor University Medical Center Proceedings October 2017 - 437
Baylor University Medical Center Proceedings October 2017 - 438
Baylor University Medical Center Proceedings October 2017 - 439
Baylor University Medical Center Proceedings October 2017 - 440
Baylor University Medical Center Proceedings October 2017 - 441
Baylor University Medical Center Proceedings October 2017 - 442
Baylor University Medical Center Proceedings October 2017 - 443
Baylor University Medical Center Proceedings October 2017 - 444
Baylor University Medical Center Proceedings October 2017 - 445
Baylor University Medical Center Proceedings October 2017 - 446
Baylor University Medical Center Proceedings October 2017 - 447
Baylor University Medical Center Proceedings October 2017 - 448
Baylor University Medical Center Proceedings October 2017 - 449
Baylor University Medical Center Proceedings October 2017 - 450
Baylor University Medical Center Proceedings October 2017 - 451
Baylor University Medical Center Proceedings October 2017 - 452
Baylor University Medical Center Proceedings October 2017 - 453
Baylor University Medical Center Proceedings October 2017 - 454
Baylor University Medical Center Proceedings October 2017 - 455
Baylor University Medical Center Proceedings October 2017 - 456
Baylor University Medical Center Proceedings October 2017 - 457
Baylor University Medical Center Proceedings October 2017 - 458
Baylor University Medical Center Proceedings October 2017 - 459
Baylor University Medical Center Proceedings October 2017 - 460
Baylor University Medical Center Proceedings October 2017 - 461
Baylor University Medical Center Proceedings October 2017 - 462
Baylor University Medical Center Proceedings October 2017 - 463
Baylor University Medical Center Proceedings October 2017 - 464
Baylor University Medical Center Proceedings October 2017 - 465
Baylor University Medical Center Proceedings October 2017 - 466
Baylor University Medical Center Proceedings October 2017 - 467
Baylor University Medical Center Proceedings October 2017 - 468
Baylor University Medical Center Proceedings October 2017 - 469
Baylor University Medical Center Proceedings October 2017 - 470
Baylor University Medical Center Proceedings October 2017 - 471
Baylor University Medical Center Proceedings October 2017 - 472
Baylor University Medical Center Proceedings October 2017 - 473
Baylor University Medical Center Proceedings October 2017 - 474
Baylor University Medical Center Proceedings October 2017 - 475
Baylor University Medical Center Proceedings October 2017 - 476
Baylor University Medical Center Proceedings October 2017 - 477
Baylor University Medical Center Proceedings October 2017 - 478
Baylor University Medical Center Proceedings October 2017 - 479
Baylor University Medical Center Proceedings October 2017 - 480
Baylor University Medical Center Proceedings October 2017 - 481
Baylor University Medical Center Proceedings October 2017 - 482
Baylor University Medical Center Proceedings October 2017 - 483
Baylor University Medical Center Proceedings October 2017 - 484
Baylor University Medical Center Proceedings October 2017 - 485
Baylor University Medical Center Proceedings October 2017 - 486
Baylor University Medical Center Proceedings October 2017 - 487
Baylor University Medical Center Proceedings October 2017 - 488
Baylor University Medical Center Proceedings October 2017 - 489
Baylor University Medical Center Proceedings October 2017 - 490
Baylor University Medical Center Proceedings October 2017 - 491
Baylor University Medical Center Proceedings October 2017 - 492
Baylor University Medical Center Proceedings October 2017 - Cover3
Baylor University Medical Center Proceedings October 2017 - Cover4
http://www.brightcopy.net/allen/bapr/30-4
http://www.brightcopy.net/allen/bapr/30-3
http://www.brightcopy.net/allen/bapr/30-2
http://www.brightcopy.net/allen/bapr/30-1
http://www.brightcopy.net/allen/bapr/29-4
http://www.brightcopy.net/allen/bapr/29-3
http://www.brightcopy.net/allen/bapr/29-2
http://www.brightcopy.net/allen/bapr/29-1
http://www.brightcopy.net/allen/bapr/28-04
https://www.nxtbook.com/allen/bapr/28-3
https://www.nxtbook.com/allen/bapr/28-2
https://www.nxtbook.com/allen/bapr/28-1
https://www.nxtbook.com/allen/bapr/27-4
https://www.nxtbook.com/allen/bapr/27-3
https://www.nxtbookmedia.com