Figure 2.

Representative macroscopic and histologic images of the explanted valve. (A) Excised specimen showing marked fibrocalcific remodeling and a single functional commissure, resulting in a unicuspid-like valve morphology. (B) Hematoxylin-phloxine-safron staining (original magnification ×15) showing marked chronic tissue remodeling including fibrosis (asterisk), calcification (open arrow), and amorphous pale pink material (solid arrow), (C) Congo Red positive (original magnification ×100), (D) with green birefringence under polarized light (original magnification ×200), consistent with amyloid.