Development of mature lamellar bone with a hematopoietic compartment in an aortic valve homograft.

Two foci of mature lamellar bone with features of remodeling and with an adjacent hematopoietic compartment were revealed for the first time in an aortic valve homograft by hematoxylin and eosin staining and polarized light microscopy. The valve had been obtained originally from a 52-year-old non-beating-heart donor and implanted as 'fresh antibiotic-preserved' into the left ventricular outflow tract of a 21-year-old man, but was explanted after six years due to valvular insufficiency. The areas close to bone showed the presence of cells resembling osteoblasts, osteoclasts and degenerating chondrocytes. Von Kossa staining disclosed a small area of dystrophic calcification in the vicinity of one bone fragment, whereas the second fragment was accompanied by only weak, diffuse calcification. These findings shows that the formation of ectopic mature bone with secondary development of the hematopoietic compartment can occur in a relatively short time, and suggest that initiators of the process may be present in the grafted valve.