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The Annals of Thoracic Surgery, Vol 25, 466-469, Copyright © 1978 by The Society of Thoracic Surgeons
CB Wright, LF Hiratzka, S Crossland, J Isner and JA Snow
Reviews of postmortem reports on patients with Whipple's disease
(intestinal lipodystrophy) describe gross valvular deformity in more than
50% with characteristic histological findings of macrophages containing
periodic acid-Schiff-positive, diastase-resistant granules. Frequently,
congestive heart failure characterizes the terminal stages. In a
58-year-old man with well-documented Whipple's disease for 5 years,
gastrointestinal, joint, and pericardial involvement apparently resolved
with medical therapy. However, 10 years later, severe aortic insufficiency
necessitated prosthetic valve replacement, at which time gross and
histological examination of the excised valve demonstrated characteristic
changes of Whipple's disease. Clinical recognition of the importance of
cardiac valvular abnormalities and of possible late cardiac decompensation
mandates close observation of patients with Whipple's disease. Corrective
operation should improve the patient's chances of survival.
ARTICLES
Aortic insufficiency requiring valve replacement in Whipple's disease
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