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Description
The hallmark anatomic change is progressive fibrosis, calcification, and fusion of the valve leaflets at their edges

1989 Oct;38(10):957-61

Fathizadeh H, Milajerdi A, Reiner , Kolahdooz F, Asemi Z

These included reduced clotting factor VIII activity, increased D-dimer and antithrombin levels, and increased levels of fibrin and fibrinogen breakdown products, as well as prolonged clotting time
and why do some patients experience residual symptoms after treatment

Lin ZH, Lu MK, Lo HC, Chang CC, Tseng AJ, Chao CH, et al
