Aschoff bodies in operatively excised atrial appendages and in papillary muscles: frequency and clinical significance

Abstract

Among 481 patients undergoing various mitral valve operations, Aschoff bodies were found in 40 (21%) of 191 operatively excised left atrial appendages, in 4 (2%) of 273 operatively excised left ventricular papillary muscles (1 per patient), and in 1 (6%) of 17 patients with both left atrial appendage and papillary muscle operatively excised. Of the total of 45 patients with Aschoff bodies, 44 preoperatively had mitral stenosis, and only 1, a 10-yr-old boy, had pure mitral regurgitation. Sinus rhythm was present in 38 (84%), and atrial fibrillation in 7 (16%). Perioperatively, only 1 of the 45 patients with Aschoff bodies had clinical or laboratory stigmata compatible with acute rheumatic fever, and 58% had an illness compatible with acute rheumatic fever at any time.