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J Thorac Cardiovasc Surg 2006;131:738-739
© 2006 The American Association for Thoracic Surgery

Brief Communication

Surgical treatment of caseous mitral valve annulus calcification

Michael J. Davidson, MD, Lawrence H. Cohn, MD *

Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass

Received for publication November 2, 2005; accepted for publication November 16, 2005.

* Address for reprints: Lawrence H. Cohn, MD, Division of Cardiac Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Email: Lcohn@partners.org).

The first 20% of the full text of this article appears below.

Mitral annular calcification (MAC) is common in the elderly population. It can cause mitral regurgitation, mitral stenosis, and heart block and can complicate attempts to repair or replace the mitral valve. Extensive MAC can undergo liquefaction and simulate an intracardiac mass. Previously this rare entity was believed to be a benign incidental finding on imaging. We describe a case of caseous MAC mimicking a cardiac tumor and causing spontaneous cerebral embolization.

Clinical Summary

A 79-year-old woman was referred to our institution after experiencing painless monocular vision loss. Examination was consistent with central retinal artery embolism. Magnetic resonance imaging revealed bilateral microvascular infarctions in the anterior circulation. Transthoracic echocardiogram and a gated chest computed tomogram (Figure 1, A) showed a 3-cm heavily calcified mass associated with the posterior mitral annulus. Her presentation was initially believed to be most consistent with embolization from intracardiac tumor.


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  		Figure 1. Appearance of the mitral annular mass on imaging. A, Computed tomographic scan showing a heavily calcified mass in the region of the posterior mitral valve. B, Intraoperative transesophageal echocardiogram (TEE) . . . [Full Text of this Article]

 



This article has been cited by other articles:


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 J. Thorac. Cardiovasc. Surg.Home page
S. C. Stamou, A. C. Braverman, and N. T. Kouchoukos
Caseous calcification of the anterior mitral valve annulus presenting as intracardiac mass
J. Thorac. Cardiovasc. Surg., July 1, 2010; 140(1): e9 - e10.
[Full Text] [PDF]


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