scholarly journals Purposeful use of multimodality imaging in the diagnosis of caseous mitral annular calcification: a case series report

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Krunoslav Michael Sveric ◽  
Ivan Platzek ◽  
Elena Golgor ◽  
Ralf-Thorsten Hoffmann ◽  
Axel Linke ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Case Series ◽  
Rare Condition ◽  
Definitive Diagnosis ◽  
Mitral Annular Calcification ◽  
Typical Structure ◽  
Benign Condition ◽  
Outer Capsule ◽  
Annular Calcification

Abstract Background Caseous mitral annular calcification (CMAC) is a rare liquefactive variant of mitral annular calcification (MAC) and superficially mimics a cardiac vegetation or abscess. CMAC is viewed as a benign condition of MAC, while MAC has clinical implications for patients’ lives. Correctly diagnosing CMAC is essential in order to avoid unnecessary interventions, cardiac surgery or even psychological suffering for the patient. Case presentation We report on 6 patients with suspected intra-cardiac masses of the mitral annulus that were referred to our institution for further clarification. A definitive diagnosis of CMAC was achieved by combining echocardiography (Echo), cardiac magnetic resonance imaging (MRI) and cardiac computed tomography (CT) for these patients. Echo assessed the mass itself and possible interactions with the mitral valve. MRI was useful in differentiating the tissue from other benign or malign neoplasms. CT revealed the typical structure of CMAC with a “soft” liquefied centre and an outer capsule with calcification. Conclusion CMAC is a rare condition, and most clinicians and even radiologists are not familiar with it. CMAC can be mistaken for an intra-cardiac tumour, thombus, vegetation, or abscess. Non-invasive multimodality imaging (i.e. Echo, MRI, and CT) helps to establish a definitive diagnosis of CMAC and avoid unnecessary interventions especially in uncertain cases.

Mitral annular calcification and valvular dysfunction: multimodality imaging evaluation, grading, and management

2021 ◽  
Author(s):  
Bo Xu ◽  
Duygu Kocyigit ◽  
Tom Kai Ming Wang ◽  
Carmela D Tan ◽  
E Rene Rodriguez ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Classification System ◽  
Multimodality Imaging ◽  
Imaging Modality ◽  
Cardiac Computed Tomography ◽  
Calcium Deposition ◽  
Mitral Annular Calcification ◽  
Imaging Evaluation ◽  
Line Imaging ◽  
Annular Calcification

Abstract Mitral annular calcification (MAC) refers to calcium deposition in the fibrous skeleton of the mitral valve. It has many cardiovascular associations, including mitral valve dysfunction, elevated cardiovascular risk, arrhythmias, and endocarditis. Echocardiography conventionally is the first-line imaging modality for anatomic assessment, and evaluation of mitral valve function. Cardiac computed tomography (CT) has demonstrated importance as an imaging modality for the evaluation and planning of related procedures. It also holds promise in quantitative grading of MAC. Currently, there is no universally accepted definition or classification system of MAC severity. We review the multimodality imaging evaluation of MAC and associated valvular dysfunction and propose a novel classification system based on qualitative and quantitative measurements derived from echocardiography and cardiac CT.

scholarly journals A Cardiac Computed Tomography–Based Score to Categorize Mitral Annular Calcification Severity and Predict Valve Embolization

2020 ◽  
Vol 13 (9) ◽  
pp. 1945-1957 ◽  
Author(s):  
Mayra Guerrero ◽  
Dee Dee Wang ◽  
Amit Pursnani ◽  
Mackram Eleid ◽  
Omar Khalique ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiac Computed Tomography ◽  
Mitral Annular Calcification ◽  
Annular Calcification

scholarly journals The “MAC” Attack: When Mitral Annular Calcification Goes Rogue! A Case Series of Mobile Mitral Annular Calcifications

CASE ◽  
2020 ◽  
Vol 4 (5) ◽  
pp. 467-472
Author(s):  
Michael Chetrit ◽  
Ossama Abou Hassan ◽  
Natalie Ho ◽  
Patrick Collier ◽  
L. Leonardo Rodriguez
Keyword(s):  
Case Series ◽  
Mitral Annular Calcification ◽  
Annular Calcification

Abstract 11452: Are Patients With Caseous Calcification of the Mitral Annulus But Without Atrial Fibrillation at Increased Risk of Cerebral Embolization?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Charles A Dietl ◽  
Christopher M Hawthorn ◽  
Veena Raizada
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Annulus ◽  
Mitral Annular Calcification ◽  
Benign Condition ◽  
Increased Risk ◽  
Cerebral Embolization ◽  
Mitral Annulus Calcification ◽  
Unusual Variant ◽  
History Of ◽  
Annular Calcification

Background: Caseous calcification of the mitral annulus (CCMA) is very uncommon, and is frequently misdiagnosed as an intracardiac tumor, thrombus, abscess, or simply as mitral annular calcification (MAC). These masses are generally believed to have a benign prognosis. The aims of this study are to increase the awareness of this unusual variant of MAC, and to determine whether patients with CCMA are at increased risk of cerebral embolization in patients with or without atrial fibrillation (AF). Methods: A comprehensive literature search was done to determine whether patients with CCMA are at increased risk of cerebral embolization, using the following search modules: caseous calcification of the mitral annulus, mitral annular calcification, cerebral embolization with mitral annulus calcification, risk of stroke with mitral annular calcification. Results: Among the 496 articles listed in PubMed.gov, ScienceDirect.com, and Google Scholar, a total of 129 patients with CCMA were identified in 85 publications, and 31 articles were reviewed to evaluate the incidence of stroke in 1800 patients with MAC. Literature review revealed that the incidence of cerebrovascular events (CVE) associated with CCMA is 18.6% (24 of 129) which is even higher than the risk of embolic CVE reported in patients with MAC, 11.6% (209 of 1800) (range 4.8% to 24.1%). Only 2 of 24 patients (8.3%) with CCMA who suffered a CVE had history of AF, whereas the majority (22 of 24, or 91.7%) of CCMA patients with a CVE did not have AF. Conclusions: Despite the fact that several reports suggest that CCMA is a benign condition, CCMA may be potentially serious, because of the increased risk of cerebral embolization, even in patients without atrial fibrillation.

scholarly journals Severe Mitral Annular Calcification: Insights from Multimodality Imaging

2014 ◽  
Vol 41 (2) ◽  
pp. 245-247 ◽  
Author(s):  
Benoy N. Shah ◽  
Sonya Babu-Narayan ◽  
Wei Li ◽  
Michael Rubens ◽  
Tom Wong
Keyword(s):  
Multimodality Imaging ◽  
Mitral Annular Calcification ◽  
Annular Calcification

scholarly journals The curious case of a massive right heart thrombosis: a case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Jessica Artico ◽  
Manuel Belgrano ◽  
Rossana Bussani ◽  
Gianfranco Sinagra
Keyword(s):  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Rare Condition ◽  
Surgical Removal ◽  
Large Area ◽  
Good Clinical Condition ◽  
Life Threatening ◽  
Thrombotic Complications ◽  
The Right ◽  
Complete Investigation

Abstract Background Intraventricular masses are a relatively rare condition ranging from asymptomatic to potentially life-threatening situations. Case summary Herein, we report a case of a 49-year-old woman under investigation for a massive right ventricular (RV) mass who underwent complete investigation for possible differential diagnosis, in the suspect of RV tumour. Multimodality imaging with cardiac computed tomography and magnetic resonance imaging showed the presence of a massive thrombus partially obliterating the right ventricle. Surgical removal of the mass showed a large area of stratified thrombosis with an underlying area of endocardial fibrosis. The patient has been then discharged in good clinical condition and with lifetime oral anticoagulation. Discussion  Massive RV thrombosis is a rare yet potentially fatal condition. Invasive management is preferable and lifetime anticoagulation is required to reduce possible downstream thrombotic complications.

scholarly journals Taming of the Tiger: A Novel Technique to Deal With Mitral Annular Calcification —A Case Series

2020 ◽  
Vol 23 (6) ◽  
pp. E793-E796
Author(s):  
Varghese Panicker ◽  
Renjith Sreekantan ◽  
Sai Suraj Kotera
Keyword(s):  
Mitral Valve ◽  
Case Reports ◽  
Treatment Options ◽  
Case Series ◽  
Mitral Valve Surgery ◽  
Paravalvular Leak ◽  
Valve Repair ◽  
Mitral Annular Calcification ◽  
Annular Reconstruction ◽  
Annular Calcification

Background: Mitral valve surgery can be challenging for patients with mitral annular calcification (MAC). The prevalence of MAC in patients who undergo mitral valve replacement is 19.9%. The  treatment options for MAC include complete decalcification and annular reconstruction with valve repair/replacement or performing a surgical valve repair or replacement without decalcification, accepting the risk of paravalvular leak. We describe three cases of mitral valve prolapse with posterior annular calcification, which were repaired using a unique technique that does not require decalcification. Case reports: The mitral annular calcification was heavy and involved most of the posterior annulus just sparing the commissures in all the three cases. Leaflet prolapse was dealt with by using neochordae, closing any clefts, and leaflet plication. Since the MAC ring was not complete and there was chance of further dilatation of the annulus, a partial annuloplasty was done using a PTFE felt (cut as strip). There was trivial to no mitral regurgitation with this technique in the immediate postoperative and five-year follow-up period echocardiography in all the three cases. Conclusion: This technique can benefit the major subset of pure mitral valve regurgitant lesions associated with MAC, which is limited to the posterior annulus.

Sign in / Sign up

Export Citation Format

Share Document