Caseous Calcification of the Mitral Annulus: Unusual Case of Spontaneous Resolution

Gramenzi, Silvana; Mazzola, Anna Alice; Tagliaferri, B; Protasoni, Giuseppe; Brusoni, Denise; d’Aloya, Gaetana; Brusoni, B

doi:10.1111/j.1540-8175.2005.04056.x

Cited by 40 publications

(32 citation statements)

References 14 publications

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“…There are only 5 cases reported in the literature where heart surgery was performed due to CCMA-induced severe mitral regurgitation and HF [5,6]. There are data that CCMA may have a regressive or progressive nature [1,10], but in the literature, we have found no data of such a rapid progression and deterioration in the clinical course, as it happened in our case.…”

Section: Discussioncontrasting

confidence: 50%

Severe Mitral Regurgitation and Heart Failure due to Caseous Calcification of the Mitral Annulus

et al. 2011

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Caseous calcification is a rare form of mitral annular calcification. Echocardiography reveals an echodense mass in the inferior mitral annulus with smooth borders and an echolucent inner core. We present a case where caseous calcification of the mitral annulus caused severe mitral regurgitation, atrial fibrillation and heart failure. Transthoracic echocardiography, transesophageal echocardiography, cardiac mag- netic resonance and computed tomography were performed and ensured the diagnosis. The mass was surgically removed and a prosthetic valve was implanted. We conclude that caseous calcification of the mitral annulus should be considered not only in the differential diagnosis of cardiac masses but also in the background of mitral regurgitation, atrial fibrillation and heart failure. This case also represents the usefulness of multimodal imaging in identifying cardiac masses.

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Section: Discussioncontrasting

confidence: 50%

Severe Mitral Regurgitation and Heart Failure due to Caseous Calcification of the Mitral Annulus

et al. 2011

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“…Most of the patients were asymptomatic or presented with dyspnea, probably unrelated to the mass. In one patient there was a spontaneous dissolution [18]. One patient had a mitral valve stenosis and another had progressive severe mitral valve regurgitation.…”

Section: Discussionmentioning

confidence: 97%

“…[13][14][15][16][17][18][19]. Alkadhi, et al [17] reported on 64-slice MDCT imaging of a similar mass with peripheral calcification and central hyperdensity.…”

Section: Discussionmentioning

confidence: 98%

Caseous calcification of the mitral annulus imaged with 64-slice multidetector CT and magnetic resonance imaging

Vanovermeire

Duerinckx

Duncan

et al. 2006

Int J Cardiovasc Imaging

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Caseous calcification of the mitral annulus is a rare entity in cardiac imaging. We present CT and magnetic resonance imaging (MRI) in a patient evaluated for severe mitral valve regurgitation with such calcified cardiac mass in the thickened basal wall of the left ventricle. Despite good visualization of the mass both with 64-slice multidetector CT and MRI, the characterization of the lesion was difficult. The most critical finding was the presence of a hyperdense mass with an even denser peripheral rim on pre-contrast CT images. The mass did not enhance after X-ray contrast agent administration. We discuss the preoperative differential for calcified intramyocardial mass.

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“…According to some authors, absence of treatment seems to be a good option in the absence of clinical manifestations [1,2]. Cases of retransformation of CCMA into CMA have been reported [1,2] and even cases of spontaneous resolution [6]. However, hemodynamic problems and strokes are an indication for curative surgery or for preventing recurrence.…”

Section: Discussionmentioning

confidence: 97%

Spontaneous fistulization of a caseous calcification of the mitral annulus: an exceptional cause of stroke

Chevalier¹,

Réant²,

Laffite³

et al. 2011

European Journal of Cardio-Thoracic Surgery

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We present the case of a caseous calcification of the mitral annulus, responsible for two strokes, in a 72-year-old female patient. The brain computed tomography (CT) scan confirmed the presence of a calcific embolus. The echocardiography showed a liquidy, pseudotumoral mass combined with numerous calcifications located in the posterior part of the mitral annulus and extending toward the inferior surface of the left ventricle. During surgery, we found a direct communication between the caseous necrosis and the lumen of the left ventricle at the level of its inferior wall. We performed a valve repair procedure and excision of the caseous necrosis, combined with injection of bioglue into the cavity, to avoid recurrence. Six months after the procedure, the patient was in good health, and had no recurrence of stroke with a satisfactory echocardiography. This is the first description of spontaneous fistulization of a caseous necrosis in the lumen of the left ventricle, explaining a new mechanism for cerebral embolism during the course of calcifying diseases of the mitral annulus.

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Caseous Calcification of the Mitral Annulus: Unusual Case of Spontaneous Resolution

Cited by 40 publications

References 14 publications

Severe Mitral Regurgitation and Heart Failure due to Caseous Calcification of the Mitral Annulus

Severe Mitral Regurgitation and Heart Failure due to Caseous Calcification of the Mitral Annulus

Caseous calcification of the mitral annulus imaged with 64-slice multidetector CT and magnetic resonance imaging

Spontaneous fistulization of a caseous calcification of the mitral annulus: an exceptional cause of stroke

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