This specimen is a Carpentier-Edwards prosthetic aortic valve. There are multiple tears in the valve
leaflets immediately adjacent to the free edges. At operation these appeared to be due to impaction
of the cusps during systole on the fairly long cut ends of the placement sutures. There was no
evidence of an infective process.
The patient had undergone aortic and mitral valve replacement three years earlier for
aortic and mitral regurgitation secondary to rheumatic fever. Evidence of incompetence of the
prosthetic valve was found on routine follow-up examination.