Coarctation of The Aorta and Bicuspid Aortic Valve

Clinical History

There are no clinical details apart from the fact that this patient had a coarctation of the aorta resected 10 days prior to death.

Pathology

The specimen is of heart laid open to display the left ventricular cavity, mitral and aortic valves. The left ventricle is dilated and its walls hypertrophied, (> 15 mm). Both mitral and aortic valves are slightly thickened. A further abnormality is present in the aortic valve. The adjacent free edges of the two coronary cusps are fused. However, the resultant septum is fenestrated and joined to the aorta superiorly by two fine strands of tissue, leaving below them an ovoid deficit 1 cm in diameter. What has been produced is a bicuspid valve, there being one large cusp above which both coronary vessels arise, and a smaller cusp. The visceral layer of pericardium and the sectioned coronary vessels appear normal. To the right of the heart is a portion of the aorta with an intact anastomosis. This is presumably the site of the former coarctation.