Surgical Treatment of a Caseous Calcification Lesion Which Originated from the Calcified Anterior Mitral Annulus in Patient on Chronic Hemodialysis

Abstract

We report a case of a caseous calcification lesion originating from a calcified anterior mitral annulus. A 59-year-old woman on chronic hemodialysis was referred to our hospital due to an elevated brain natriuretic peptide value. Transthoracic echocardiography demonstrated moderate aortic valve stenosis with regurgitation and a pendulous mass in the left ventricular outflow tract, and therefore we perfomed. The patient underwent resection of the mass with aortic valve replacement. Pathological examination of the mass revealed interstitial calcium deposits but without tumors or inflammatory cells. We speculated that the cardiac mass was caseous calcification which originated from a severely calcified mitral annulus based on its echocardiographic and pathological features.