Granulation Tissue (#190 32-43000)
Deep to the vegetation, one may see granulation tissue, representing early healing. This eventually leads to scarring of the valve leaflet, with functional sequelae of stenosis and/or incompetence of the valve.

2-9 Bacterial Endocarditis
In this example, there are vegetations covering the sewing ring of an artificial valve. Transient bacteremia of even low-virulence organisms could result in infection of platelet thrombi on the valve ring. Endocarditis could result in dehiscence of the prosthesis.