Key result
In a patient with severe rheumatic mitral stenosis and massive left atrial calcification, mitral valve replacement and thrombus evacuation were complicated by fatal postoperative right-sided heart failure.
Why the study?
Massive left atrial calcification is rare, complicating surgical management and necessitating careful preoperative assessment of calcification extent.
Case Report (n=1)
No
Highlights the importance of comprehensive preoperative imaging to assess the extent of left atrial calcification in rheumatic mitral stenosis to optimize surgical planning and outcomes.
Preoperative LA calcification assessment may guide incision planning in rheumatic MS surgery; leaves open standardized protocols from larger series.
Massive calcification of the left atrium (LA), known as coconut atrium or porcelain atrium, is rare.This study emphasized the importance of assessing the extent of calcification in the LA before surgery.We present a case of a 55-year-old woman with severe, long-standing rheumatic mitral stenosis complicated by massive LA calcification.Mitral valve replacement surgery and thrombus evacuation were performed.Calcified LA complicates management, particularly in determining the surgical incision site, and alters atrial wall hemostatic properties while increasing right ventricular afterload.Available diagnostic modalities allow comprehensive preoperative planning for left atrial calcification.These methods identify specific case concerns and variations to optimize outcomes.
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Atmadikoesoemah et al. (2024) conducted a case report in Severe long-standing rheumatic mitral stenosis with massive left atrial calcification (n=1). Mitral valve replacement surgery and thrombus evacuation was evaluated on Clinical outcome. In a patient with severe rheumatic mitral stenosis and massive left atrial calcification, mitral valve replacement and thrombus evacuation were complicated by fatal postoperative right-sided heart failure.
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