• Document number of the leaflets received and presence of chordae tendineae and papillary muscle.
• Measure dimensions of each leaflet but also the combined length of the free edges (circumference) of the free edge which would reflect possible stenosis. (Normal valve circumferences: mitral 9-10cm, aortic 6-7cm, pulmonary 7-8cm, tricuspid 11-12cm.)
• Note the shape of the leaflets, distortion, fusion, calcification, fibrosis, vegetation.
• Take photograph of unusual findings (leaflets with vegetation or perforation). 
• Sample each leaflet from base to edge, submit 3-4 representative sections in one cassette.  Decalcify in quick Decal solution if necessary.
• If history of endocarditis clinically, submit entirely and request gram stains.

• Each leaflet from base to edge, including extraneous tissues.
• One or more blocks of any vegetations.

Internal use only

Received without fixative/in formalin, labeled _____ and “_____”, are ___ (e.g. one, two, three) shaped separate cardiac leaf lets measuring __ cm and __ cm in greatest width, respectively, with a ___ cm combined length of the free edges.  One leaf let shows ____ (e.g. marketed distortion, thickening with calcification).  The other leaf let is creamy white, thin and smooth on surface with  __ cm attached chordae tendineae / papillary muscle that is / are ___ (unremarkable).  No vegetation is identified in any of that leaf lets.  Representative sections of the specimen of submitted in #___ .

___ blocks, __ H&E, __ decal