Massive left atrial calcification: a case report and review of the literature (original) (raw)
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Massive left atrial calcification associated with mitral valve replacement
Journal of cardiovascular ultrasound, 2010
Calcification of the left atrium can be observed in patients with a long-lasting rheumatic heart disease. However, massive calcification of the atrial wall, so called porcelain or coconut atrium is very rare and has been generally reported only as incidental radiographic findings. We report a case of massive and firm calcifications at the left atrium in patient who underwent mitral valve replacement.
Massive calcification of the left atrium: Surgical implications
The Annals of Thoracic Surgery, 1995
Background. Massive calcification of the atrial walls ("porcelain atrium") is a rare condition that usually has been reported as an incidental radiologic finding. Methods. Between January 1988 and June 1993, 971 patients underwent valvular operation at our institution; 21 patients showed extensive calcification of the left atrium. In 8 patients the calcification was massive, involving almost all the atrial surface. The diagnoses were established by radiology and were confirmed at operation. The mean age of these patients (4 men, 4 women) was 55 ± 9.6 years. All had rheumatic valve disease, were on atrial fibrillation, and had undergone at least one operation previously. Pulmonary artery pressure was severely increased, even up to systemic levels, in all patients except 1. Total endoatriectomy of the left atrium and mitral valve replacement were performed. No patient was lost during the follow-up. Results. Hospital mortality rate was 12.5% (1 patient) and 2 patients died in the late postoperative period. None of these deaths are attributable to the surgical procedure. Conclusions. In toto endoatriectomy of a massively calcified atrium is an easy to perform technique that helps to replace the mitral valve and close the atrial wall.
Serpigenous Calcification in the Heart
Pediatric Cardiology, 2009
A 51-year-old perimenopausal woman was admitted for evaluation of insidious-onset of congestive cardiac failure and atrial fibrillation. She was known to have moderate mitral regurgitation from childhood, which was considered to be of probable rheumatic origin. She was not habituated to tobacco and her two pregnancies were uneventful. Hematogram and blood chemistries were normal and there was no contributory family history.
Cardiac Restriction Secondary to Massive Calcific Deposits in the Left Ventricular Cavity
The American Journal of Cardiology, 2014
Described herein are clinical and necropsy findings in a 61-year-old woman with fatal left ventricular diastolic failure secondary to massive calcific deposits primarily within the left ventricular cavity. At age 3, an isthmic aortic coarctation was resected, and at age 44, a stenotic congenitally bicuspid aortic valve was replaced. The cause of the intracavitary calcific deposits remains unclear, but surgical resection of the deposits has been an effective form of therapy. Ó 2014 Elsevier Inc. All rights reserved. (Am J Cardiol 2014;113:1442e1446) Calcific deposits are common in the heart particularly in older individuals and especially in atherosclerotic plaques in coronary arteries, in aortic valve cusps, and in the mitral annulus. 1 These deposits may also occur but far less commonly in other areas of the heart. In 1984, Silver et al 2 described clinical and necropsy findings in a 56-year-old woman with numerous calcific deposits in the left ventricular cavity causing severe impairment to left ventricular filling. This report describes clinical and necropsy findings in a similar patient and reviews other reported cases of large, mainly intracavitary, left ventricular calcific deposits.
Mitral Annular Calcification Mimicking an Intracardiac Mass
Echocardiography, 1995
We present two patients with atypical mitral annular calcification. I n both instances, the annular calcification presented as a mass localized to the atrioventricular junction. I n one instance, there was a mobile element of the mass which resulted in an embolic stroke. I n conclusion, atypical mitral annular calcification can mimic a n intracardiac mass. It is usually recognized by its typical location and echocardiographic characteristics. (ECHOCARDIOGRAPm, Volume 12, November 1995) mitral annual calcification, transesophageal echocardiography, transthoracic echocardiography, intracardiac mass lesions Idiopathic calcification of the mitral annulus is a chronic degenerative process and is one of the most common cardiac abnormalities found at autopsy. It has a characteristic ring-like appearance by echocardiography. The M-mode feature includes a dense echo band behind the posterior mitral leaflet, with its motion parallel to that of the posterior left ventricular wall. A two-dimensional echocardiogram usually demonstrates the site and seventy of the annular calcification. Type I calcification involves the medial segment of the annulus and/or extends into the anterior mitral leaflet. Type I1 calcification involves the central andor lateral segment of the annulus. Mild calcification involves one segment, moderate calcification involves two, and severe calcification involves three segments of the ann~lus.l-~ In most instances, mitral annulus calcification is of little functional consequence. However, when the calcification is severe, it may be associated with mitral valve regurgitation and/or stenosis, conduction disturbances due to the involvement of ventricle septum and the conducting system, Fax: 313-876-1952. and may be a nidus for endocarditis.1-6 In this article, we present two patients with atypical mitral annular calcification mimicking an intracardiac mass by echocardiography and resulting in a stroke in one of the individuals.
European Journal of Echocardiography, 2009
A 71-year-old woman with a history of childhood pulmonary tuberculosis was admitted to our hospital for exertional dyspnoea (NYHA functional class II). Transthoracic and transoesophageal echocardiography demonstrated moderate to severe mixed mitral valve disease due to massive mitral annular calcification (MAC) and extensive infiltrative calcification of the atrioventricular groove. In addition, a very uncommon intramyocardial calcification of the ventricular septum and the lateral free wall was diagnosed. This case demonstrates a rare combination of mitral valve disease secondary to MAC, and a small hypertrophied left ventricle, as well as epipericardial and myocardial calcification likely due either to the massive MAC with myocardial extension or to former tuberculous perimyocarditis. The multidimensional imaging approach, which has been used in this particularly case, provided an excellent visualization and clinical evaluation of this rare finding.