Native cardiac valves may undergo calcification in the setting of chronic injury, subsequently impeding normal valve structure and function. In the same setting, there may be evidence of metaplasia—specifically osseous metaplasia—with lamellar bone admixed with dystrophic calcification. In this study, the histologic features of 123 native aortic valves (identified from 1094 sequentially reviewed native valves of all types that included a total of 754 aortic valves) with osseous metaplasia are focused upon, as well as correlation with other histopathologic features, and clinical and echocardiographic findings. Osseous metaplasia was identified in aortic and significantly less frequently in mitral valves, and never in tricuspid or pulmonic valves. Notable observations included that osseous metaplasia in aortic valves were seen in patients with greater body mass index, and less commonly identified in patients with a history of autoimmune disease. Aortic valves with osseous metaplasia were more commonly tricuspid (as opposed to bicuspid), and with smaller aortic valve area and greater peak and mean gradients. The rate of osseous metaplasia in aortic valves increased with increasing degree of stenosis and decreasing degree of regurgitation. The rates of the presence of chondromatous metaplasia, smooth muscle, arterial vessels, capillary bed formation, chronic inflammation, and hemosiderin laden macrophages were greater in aortic valves with osseous metaplasia compared to valves without osseous metaplasia. Further investigation is required to determine potential physiologic and/or pathologic consequence of the presence of valvular osseous metaplasia.

在慢性损伤的情况下，天然心脏瓣膜可能会发生钙化，从而阻碍正常的瓣膜结构和功能。在相同的情况下，可能有化生的证据——特别是骨化生——板层骨与营养不良性钙化混合。在这项研究中，123 个自体主动脉瓣（从 1094 个依次审查的所有类型的自体瓣膜中确定，包括总共 754 个主动脉瓣）骨化生的组织学特征，以及与其他组织病理学特征的相关性，以及临床和超声心动图结果。在主动脉中发现了骨化生，在二尖瓣中发现的频率明显较低，而在三尖瓣或肺动脉瓣中从未发现过。值得注意的观察结果包括，在体重指数较高的患者中观察到主动脉瓣的骨化生，而在有自身免疫性疾病病史的患者中较少发现。具有骨化生的主动脉瓣更常见的是三尖瓣（与二尖瓣相反），主动脉瓣面积更小，峰值和平均梯度更大。主动脉瓣骨化生率随着狭窄程度的增加和反流程度的降低而增加。与没有骨化生的主动脉瓣相比，有骨化生的主动脉瓣中软骨瘤化生、平滑肌、动脉血管、毛细血管床形成、慢性炎症和载有含铁血黄素的巨噬细胞的存在率更高。