Normal Mitral Valve (Aged)



This atrioventricular (mitral) valve was excised from a dilated ventricle from an aged patient. The three layers (from top to bottom, atrialis spongiosa and fibrosa) are shown. There are some smooth muscle cells in the atrialis layer towards the base of the leaflet (see Movat stain). The atrialis layer has elastic lamellae (black lines in the Movat stain). This leaflet also shows a small amount of adipose tissue in the spongiosa layer, this finding is not pathologic. The chordae tendineae show dense fibrous tissue and insert into the fibrosa layer of the leaflet. The free border of the leaflet shows a pale appearance in the H&E stain, which shows a light increase of mucopolysaccharides (green) in the Movat stain. This is a common finding in normal valves from aging patients. The mucopolysaccharide rich stroma is very resistant to impact and is located in the coaptation area of the leaflet, where it can absorb the impact of constant closure during the cardiac cycle without fraying.



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