Key result
Contrast-enhanced cardiac CT confirms atypical caseous calcification of the anterior mitral annulus, allowing deferred surgery.
Why the study?
Caseous calcification of the mitral annulus is typically benign and most commonly involves the posterior mitral annulus, but atypical locations can cause diagnostic uncertainty.
Case Report (n=1)
Cardiac CT can accurately diagnose atypical caseous calcification of the mitral annulus, preventing unnecessary surgical excision.
Answers are grounded in this paper and cite their sources.
May support CT to defer surgery in atypical mitral annular calcification; leaves open prospective validation.
A 61-year-old asymptomatic woman was referred for echocardiography to evaluate recently detected systolic murmur. Transthoracic echocardiography revealed an echodense obstructive mass in the left ventricular outflow tract of unclear origin. Subsequent transesophageal echo suggested an intracardiac calcified tumor and recommended surgical excision. Contrast-enhanced cardiac computed tomography (CT) confirmed a well-defined lobulated mass adherent to the anterior mitral valve leaflet, the non-enhanced scout view revealed marked hyper-attenuation confirming diffuse calcification. Caseous calcification was diagnosed and surgery was deferred. Caseous calcification is typically benign and most commonly involves the posterior mitral annulus. Our patient displayed an atypical location of exuberant mitral annular calcification.
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Plank et al. (2013) conducted a case report in Caseous calcification of the mitral annulus (n=1). Contrast-enhanced cardiac computed tomography was evaluated on Diagnosis of caseous calcification. Contrast-enhanced cardiac computed tomography confirmed a diagnosis of atypical caseous calcification of the anterior mitral annulus in a 61-year-old woman, allowing surgery to be deferred.
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