Yoshinori Enomoto
Kimitsu Chuo Hospital, Japan
Title: Serial Changes on Computed Tomographic Findings of Caseous Calcification of the Mitral Annulus
Biography
Biography: Yoshinori Enomoto
Abstract
A 74-year-old female with interstitial pneumonia and old myocardial infarction was admitted with stroke because of calcific emboli. Caseous calcification of the mitral annulus was detected using computed tomography (CT) and transthoracic echocardiography during the follow-up of the interstitial pneumonia and myocardial infarction, respectively. On recent examination, echocardiography showed caseous calcification of the mitral annulus. CT revealed an oval calcification with a homogeneous density in and a scattered calcification under the posterior mitral annulus, which was detected for the first time and could not be detected by echocardiography. Rupture of the caseous calcification was suspected. Surgical treatment was postponed because the interstitial pneumonia worsened. CT performed during treatment of pneumonia showed changes in the shape and density of caseous calcification; however, scattered calcification under the mitral annulus persisted. Operative findings were consistent with signs on CT, i.e., a white, soft, plaster-like content and a similar scattered material around the chordae of the posterior leaflet. The sequences of changes of caseous calcification of the mitral annulus obtained by CT suggest its importance as a follow-up tool and indicate the necessity and timing of surgery.