Jonika M Weerasekare, Fang Zhou, Adam H Skolnick, Hasan Jilaihawi, Mathew R Williams, Surendra Dasari, Ellen D McPhail, Jason D Theis, Linda N Dao, John P Bois, Joseph J Maleszewski, Melanie C Bois
Herein we present a case of an 80-year-old gentleman who presented with exertional dyspnea status post aortic valve replacement with #23 Trifecta pericardial St. Jude aortic bioprosthetic valve (BV) 12 years prior. He subsequently underwent valve re-replacement due cusp calcification. Histologically, the surgically explanted BV revealed Congophilic deposits with birefringence under cross-polarized light. Extensive work-up identified no systemic source of amyloid in this patient. Liquid chromatography-tandem mass spectrometry-based (LC-MS/MS) proteomics showed the amyloid was composed of human-origin amyloid signature proteins (apolipoprotein A4, apolipoprotein E, serum amyloid P) and human-origin mu heavy chains...
August 26, 2022: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology