Serial Assessment of Liquefaction Necrosis of Mitral Annular Calcification by Echocardiography and Multislice Computed Tomography

A n asymptomatic 54-year-old man, who had been on hemodialysis for 11 years because of chronic renal failure caused by chronic glomerulonephritis, was observed in our hospital. In November 2002, an aortic valve replacement was performed because of severe aortic stenosis. Preoperative echocardiography demonstrated mitral annular calcification (MAC) at the base of the posterior mitral annulus (Figure Computed tomography of the heart also identified the MAC (Figure In November 2004, follow-up echocardiography revealed enlargement of the MAC, which was detected as a spherical dense echogenic calcified mass (3621 mm) with a central echolucent area (Figure Trivial mitral regurgitation was observed. Electrocardiographic gated cardiac multislice computed tomography confirmed that the mass had a high density but also contained a low-density area that was thought to be soft tissue (Figure, D). Multislice computed tomography coronary angiography showed that the mass had no feeding artery. These findings suggested that this mass was a liquefaction necrosis of the