Key result
Histopathology after double-valve replacement reveals extensive monosodium urate crystal deposition in the aortic valve.
Why the study?
Tophaceous involvement of the aortic valve in patients with combined valvular heart disease and gout is rarely documented and requires histopathological confirmation.
Case Report (n=1)
This case illustrates an extremely rare incidence of tophaceous gout directly involving the aortic valve, definitively diagnosed postoperatively utilizing De Galantha’s histopathological staining technique.
We present the case of a patient with combined valvular heart disease and a history of gout. Following surgical replacement of the aortic and mitral valves, histopathological examination revealed extensive deposition of monosodium urate (MSU) crystals within the aortic valve leaflets. The lesion exhibited a central crystalline core, surrounded by a corona zone and fibrous vascular tissue. The nature of the urate crystals was confirmed using the classical, but rarely applied today - De Galantha’s staining technique. This method allows precise visualization of crystal deposits under light microscopy at various magnifications. No specific pathological findings were identified in the examined specimens from the mitral valve or in the thrombotic mass excised from the left atrium. Based on the histopathological findings, a definitive diagnosis of tophaceous involvement of the aortic valve was established.
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Stoitsev et al. (2026) conducted a case report in Tophaceous aortic valve gout / Combined valvular heart disease (n=1). Surgical aortic and mitral valve replacement was evaluated. Histopathological examination following surgical replacement of the aortic and mitral valves revealed extensive deposition of monosodium urate crystals within the aortic valve leaflets.
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