histologic findings in the heart-valve leaflets in close proximity to the verrucae , like experimental studies reported by others , suggest that in association with severe systemic disease there appears a process consisting of degenerative changes in valve collagen and ground substance , with subsequent denudation of endothelium , localized almost entirely to the apposing leaflet surfaces of the left-heart valves .
C1708337
heart-valve leaflets
C1708664
leaflet