Abstract

RESTREPO, Gustavo; AHUMADA, Salim  and  TRESPALACIOS, Erik. Liquefactive necrosis of the mitral ring. Rev. Colomb. Cardiol. [online]. 2013, vol.20, n.5, pp.320-324. ISSN 0120-5633.

Calcification of the mitral annulus is a chronic degenerative process of the mitral valve fibrous ring which involves the posterior ring and has similar risk factors as those of atherosclerosis. Liquefactive or caseous necrosis of the mitral annulus is a less recognized and described pathology which consists of an extensive periannular calcification with characteristic appearance of a large spherical mass with a central echolucent area, similar to a mass or tumor. It is composed of a mixture of calcium, fatty acids and cholesterol and is often confused with myocardial abscesses, tumors or thrombi, and in some cases may lead to unnecessary surgical procedures. Its finding is incidental during echocardiography, and is usually associated with a benign prognosis, although sometimes can compromise functionally the mitral valve and trigger insufficiency or significant stenosis from a clinical point of view. We report the case of a 63 year old female patient with liquefactive necrosis initially misdiagnosed as atrial thrombus who could have been subjected to an unnecessary surgical procedure. Characteristic images and differential diagnosis of this pathology are discussed.

Keywords : mitral valve; necrosis; calcium; echocardiography.

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