Calcific Degenerative Mitral Disease

  • Teerapat YingchoncharoenEmail author


A 70-year-old woman presented to her primary physician with progressive shortness of breath. She was found to have atrial fibrillation and 2/6 pansystolic murmur at the left lower parasternal border on physical examination. Transthoracic echocardiography (TTE) showed mild mitral regurgitation and a cardiac mass at the atrioventricular (AV) groove area. She was referred to our institute for cardiac mass removal (Figs. 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, and 3.7).


Calcification Radiation valve disease Mitral stenosis 

Supplementary material

Video 3.1

Transthoracic echocardiography (TTE), parasternal long-axis view showing a mass with round, smooth borders and a heterogeneous echo density located at the posterior mitral annulus (AVI 5136 kb)

Video 3.2

TTE, apical four-chamber view showing a posterior mitral annulus mass (AVI 6292 kb)

Video 3.3

TTE, apical two-chamber view showing a posterior mitral annulus mass (AVI 5368 kb)

Video 3.4

Three-dimensional (3D) TTE, parasternal long-axis view again showing a mass with round, smooth borders and a heterogenous echo density located at the posterior mitral annulus (AVI 1511 kb)

Video 3.5

3D TTE, mitral valve viewed from left atrium showing posterior mitral annulus prominence (AVI 4879 kb)

Video 3.6

Cardiac CT scans with multiplanar reconstruction confirmed the diagnosis and showed an intracardiac mass measuring 3.4 × 4.7 cm involving both anterior and posterior mitral annulus with extension into the left atrium (LA) wall. The periphery of this mass is densely calcified in spots, whereas the central portion has density of approximately 400 Hounsfield units, consistent with liquefaction of calcified mitral annulus (AVI 2304 kb)

310450_1_En_3_MOESM7_ESM.avi (738 kb)
Video 3.7 3D CT reconstruction showing the extension of the mitral annular calcification mimicking a cardiac mass (AVI 738 kb)
Video 3.8

(AVI 2172 kb)

Video 3.9

(AVI 3105 kb)


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineCleveland ClinicClevelandUSA

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