A Case of Caseous Calcification in the Left Ventricular Outflow Tract with Loss of Consciousness / 日本心臓血管外科学会雑誌

<p>A 61-year-old woman presented with loss of consciousness. Echocardiography revealed a hypoechoic, round mass of 12×13 mm with a smooth border in the left ventricular outflow tract, leading to a diagnosis of loss of consciousness caused by left ventricular outflow tract obstruction, and surgical excision of the mass was performed. The mass, with a smooth, elastic soft surface and filled with yellow, creamy contents, was observed within a range from the subannular region of the left coronary cusp to the anterior mitral leaflet. Pathological examination showed central degeneration and liquefaction, as well as cystic, coarse-granular calcium deposition surrounded by inflammatory cell infiltration and fibroblast proliferation. No tumor cells were seen. Abscess was excluded by preoperative clinical presentations, hematologic data, and culture testing, and thus the mass was considered as caseous calcification of the mitral annulus. Here, we report a case of caseous calcification of the mitral annulus, a rare nonneoplastic lesion thought to be a variant of mitral annular calcification, with literature review.</p>

A Case of Caseous Calcification of a Mitral Annulus with Mitral Regurgitation and Ischemic Heart Disease / 日本心臓血管外科学会雑誌

Caseous calcification of mitral annulus is a rare disease characterized by tumors of the mitral cusps. Operative case reports, however, are rare because this lesion seldom negatively affects hemodynamics. We encountered a 67-year-old female case of mitral regurgitation with caseous calcification of mitral posterior annulus due to ischemic heart disease and performed mitral valve replacement and CABG. The excision of the mitral thickened lesion resulted in a defect of the mitral annulus, which needed to be repaired with an autologous pericardial patch. We mainly report the intraoperative findings of this case.

Infective endocarditis and caseous calcification of the mitral annulus: The odd couple / La endocarditis infecciosa y la calcificación caseosa del anillo mitral: la extraña pareja

Caseous calcification of the mitral annulus is an infrequent echocardiographic finding. The differential diagnosis includes other entities like tumors, abscess or thrombus. Both cardiac CT and cardiac MRI may be useful for its definitive diagnosis.

La calcificación caseosa del anillo mitral es un hallazgo ecocardiográfico poco frecuente. Debe hacerse el diagnóstico diferencial con otras entidades tales como tumores, abscesos o trombos. Para su diagnóstico definitivo además del ecocardiograma tanto el TC cardiaco como la Cardio RM pueden ser de utilidad.