Caseous calcification of the mitral annulus; scary image during robotic surgery.
Serkan AsilEnder MuratVeysel Özgür BarışSuat GörmelMurat ÇelikUygar Çağdaş YükselHasan Kutsi KabulCengiz BolcalPublished in: Journal of cardiac surgery (2020)
Caseous calcification of the mitral annulus (CCMA) is a very rare form of mitral annular calcification (MAC). CCMA accounts for 0.63% of all cases and 0.06-0.07% of the total population and usually seen in elderly and female patients. It mostly affects the posterior leaflet of the mitral valve. The pathogenesis of CCMA remains unclear. Hypercholesterolemia and the dissolution of lipid-laden macrophages may be implicated in liquefaction necrosis. CCMA is composed of a mixture of calcium, fatty acid, and cholesterol. The name "caseous" comes from the cheese-like or toothpaste-like consistency of the mass. Cardiac magnetic resonance imaging may help in differentiating MAC from CCMA and should perform. The first treatment option should be conservative treatment because of surgical complications of the procedure. We presented a case report which is about CCMA with preoperative and intraoperative robotic images.
Keyphrases
- mitral valve
- left ventricular
- left atrial
- chronic kidney disease
- end stage renal disease
- magnetic resonance imaging
- fatty acid
- aortic valve
- ejection fraction
- deep learning
- aortic stenosis
- newly diagnosed
- minimally invasive
- prognostic factors
- patients undergoing
- cardiovascular disease
- heart failure
- peritoneal dialysis
- cardiovascular events
- machine learning
- risk assessment
- atrial fibrillation
- low density lipoprotein
- replacement therapy
- patient reported