Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism and management implications

Poonam Puri; Radha Sarma; Enrique L Ostrzega; Padmini Varadarajan; Ramdas G Pai

doi:10.1016/j.echo.2005.01.023

Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism and management implications

J Am Soc Echocardiogr. 2005 Oct;18(10):1106. doi: 10.1016/j.echo.2005.01.023.

Authors

Poonam Puri¹, Radha Sarma, Enrique L Ostrzega, Padmini Varadarajan, Ramdas G Pai

Affiliation

¹ Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California 90033, USA.

PMID: 16198892
DOI: 10.1016/j.echo.2005.01.023

Abstract

We report a case of massive posterior mitral annular calcification causing severe systolic anterior motion of the anterior mitral leaflet and dynamic left ventricular outflow tract obstruction. Mechanism of genesis of systolic anterior motion by this unusual mechanism is illustrated. Importance of recognizing this mechanism and its implications for surgical therapy are discussed. Our patient also had liquefaction necrosis of mitral annular calcification causing its extension into left ventricular myocardium mimicking a tumor.

Publication types

Case Reports

MeSH terms

Calcinosis / complications*
Calcinosis / diagnostic imaging*
Calcinosis / surgery
Coronary Artery Bypass
Diagnosis, Differential
Female
Heart Neoplasms / diagnostic imaging
Heart Valve Prosthesis Implantation
Humans
Middle Aged
Mitral Valve Stenosis / complications*
Mitral Valve Stenosis / diagnostic imaging*
Mitral Valve Stenosis / surgery
Severity of Illness Index
Treatment Outcome
Ultrasonography
Ventricular Dysfunction, Left / diagnostic imaging
Ventricular Dysfunction, Left / etiology
Ventricular Dysfunction, Left / prevention & control
Ventricular Outflow Obstruction / diagnostic imaging*
Ventricular Outflow Obstruction / etiology*
Ventricular Outflow Obstruction / prevention & control