SM

New Osler 04 - Aortic valve: Bicuspid

Enlarge Descriptive Card Log Book Entry

Rodin Number:
E Number: 50
Donor: Osler
Date: 1880
Size (H x W cm): 9 x 8.5

The specimen shows fusion of the left and right leaflets, with the two coronary ostia clearly visible above (arrows). The specimen entry number “50” can be seen on the back view (B).

B

Click on caption to enlarge image.

Comment

Although there are some discrepancies, the specimen is similar to the one described by Osler in Case 2 of the Montreal General Hospital Reports 1880 I: 235. Moreover, the patient is described as “M.B.” in both the MGH Reports and the logbook entry. Thus it seems likely that this is indeed Osler’s MGH Report specimen. The specimen was discovered by accident in the general Museum collection storage area.

In Osler’s remarks on this and six other examples in the MGH Reports, he recognizes that the abnormality is congenital and speculates that it is likely to be a malformation rather than the result of an inflammatory process. In a paper on the same topic in the Journal of the American Medical Association (JAMA. 1886;VII(2):49-50) he states that he identified 17 cases of bicuspid valve in "over eight hundred autopsies at the MGH". He proceeds to give a short summary of these ― two from patients who died suddenly from "cardiac syncope" and 12 from those who had "pictures of chronic aortic insufficiency"; four were incidental findings. He again suggests that the condition most likely represents a congenital developmental abnormality.

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