Swinging Calcified Amorphous Tumors With Related Mitral Annular Calcification

doi:10.1016/j.athoracsur.2015.09.019

The Annals of Thoracic Surgery

Volume 101, Issue 4, April 2016, Pages e103-e105

https://doi.org/10.1016/j.athoracsur.2015.09.019 Get rights and content

Among cardiac calcified amorphous tumors, the mitral annular calcification–related calcified amorphous tumor is extremely rare. We herein describe 3 surgical cases of swinging calcified amorphous tumor with related mitral annular calcification. The clinical, echocardiographic, and pathophysiologic features are reported here together with a brief review of the literature.

Section snippets

Patient 1

A 66-year-old woman who had been on hemodialysis for 21 years because of diabetic nephropathy was referred to our hospital with a diagnosis of arteriosclerosis obliterans. A chest computed tomography (CT) revealed a calcified mitral annulus. Preoperative transthoracic echocardiography revealed a 15 mm highly mobile left atrial mass attached to the posterior MAC. Additional transesophageal echocardiography also revealed a 15 mm high-echoic mobile mass adherent to the posterior MAC. Because of

Comment

Among cardiac CATs, MAC-related CAT is extremely rare, and only a few cases have been reported 2, 3, 4. Almost all patients with MAC-related mobile components (including those with MAC-related CATs) suffered from hemodialyzed end-stage renal disease, and the mobile components apparently mimicked valve vegetation 2, 3, 4, 5, 6. Mitral annular calcification is a common degenerative disorder in the elderly, particularly in women and patients with kidney disease 7, 8. In our cases, all 3 patients

References (8)

C. Reynolds et al.
Calcified amorphous tumor of the heart (cardiac CAT)
Hum Pathol
(1997)
H. Kubota et al.
Cardiac swinging calcified amorphous tumors in end-stage renal failure patients
Ann Thorac Surg
(2010)
J.C. Eicher et al.
Possible association of thrombotic, nonbacterial vegetations of the mitral ring-mitral annular calcium and stroke
Am J Cardiol
(1997)
T. Kawata et al.
Wavering calcified amorphous tumor of the heart in a haemodialysis patient
Interact Cardiovasc Thorac Surg
(2013)

There are more references available in the full text version of this article.

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Citation Excerpt :
Recurrence has been previously reported in a patient who underwent incomplete right ventricular CCAT resection [7]. Additionally, a study reported that superimposed CCATs on MAC might represent one of the causes of MAC-induced stroke [8]. In conclusion, MV replacement and calcified lesion coverage through patch repair for CCAT with MV perforation should be considered an effective solution for preventing postoperative systemic embolization recurrence.
Cardiac calcified amorphous tumors are rare non-neoplastic intracavitary masses. Herein, we report a case of a 75-year-old woman who presented with dyspnea on exertion and multiple cerebral infarctions 3 months prior. Transthoracic echocardiography showed severe mitral regurgitation from the posterior mitral leaflet with valve perforation and severe mitral annular calcification. In addition, we observed a 13 mm mobile high echogenic mass, suggesting healed infective endocarditis. The mass was successfully resected, and the mitral valve was replaced with a bovine pericardial patch for the decalcified annulus. Histopathological examination confirmed cardiac calcified amorphous tumor; the postoperative course was uneventful. Mitral valve replacement and annulus patch repair effectively prevented postoperative recurrent systemic embolization.
<Learning objective: Calcified amorphous tumor (CAT) is a risk factor for systemic embolism. Cardiac CAT destroying the mitral valve tissue and causing mitral valvular disease have been scarcely reported. We present a case of cardiac CAT with mitral valve perforation and suspected systemic embolization, treated successfully through mitral valve replacement and calcified lesion coverage by surgical resection and patch repair.>
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Case reportSwinging Calcified Amorphous Tumors With Related Mitral Annular Calcification

Section snippets

Patient 1

Comment

Hum Pathol

Ann Thorac Surg

Am J Cardiol

Wavering calcified amorphous tumor of the heart in a haemodialysis patient

Interact Cardiovasc Thorac Surg

Case report
Swinging Calcified Amorphous Tumors With Related Mitral Annular Calcification