International Journal of Cardiovascular Sciences. 01/Apr/2017;30(2):177-80.

Caseous Necrosis of the Mitral Valve: Imaging Methods Allow the Diagnosis and Prevent Surgery

Rodrigo de Moura Joaquim, Edileide de Barros Correia, Suéllen Lacerda Bezerra, Ibraim Masciarelli Francisco Pinto, Tiago Senra Garcia dos Santos, Fabiano de Castro Albrecht

DOI: 10.5935/2359-4802.20170021

Introduction

Calcification of the mitral annulus (CMA) is defined as a chronic degeneration of the mitral annulus fibrous involving mainly the posterior annulus. It is a common condition in the elderly, especially in women, and is associated with hypertension. Caseous necrosis of the mitral valve (CNMV) is a rare and less known CMA variant with a prevalence of 0.64%, which can reach up to 2.7% in autopsy studies of patients with CMA.

On echocardiography, CNMV appears as a large rounded or semilunar echodense mass, with a liquid filling and central echolucency, similar to a periannular tumor., The mechanism of liquefaction and caseification are still not well understood, but it is believed to occur due to changes in calcium metabolism.

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Caseous Necrosis of the Mitral Valve: Imaging Methods Allow the Diagnosis and Prevent Surgery

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