Related Experiment Video
Updated: Aug 15, 2026
08:42
Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism
Poonam Puri1, Radha Sarma, Enrique L Ostrzega
1Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California 90033, USA.
Summary
Massive posterior mitral annular calcification can cause severe systolic anterior motion and dynamic left ventricular outflow tract obstruction. Recognizing this unusual mechanism is crucial for appropriate surgical management.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pathology
Background:
- Mitral annular calcification (MAC) is a common finding, typically associated with mitral regurgitation or stenosis.
- Posterior MAC is less common and its association with dynamic left ventricular outflow tract (LVOT) obstruction is rare.
- Systolic anterior motion (SAM) of the anterior mitral leaflet is usually associated with hypertrophic cardiomyopathy.
Observation:
- A case of massive posterior mitral annular calcification is presented.
- This calcification led to severe systolic anterior motion of the anterior mitral leaflet.
- The patient exhibited dynamic left ventricular outflow tract obstruction.
Findings:
- The study illustrates the mechanism by which posterior MAC causes SAM and LVOT obstruction.
- Liquefaction necrosis of the MAC was observed, extending into the left ventricular myocardium.
- This extension mimicked a cardiac tumor, presenting a diagnostic challenge.
Implications:
- Recognizing this unusual mechanism of SAM is critical for accurate diagnosis.
- Understanding these implications is vital for guiding surgical therapy in affected patients.
- The findings highlight the diverse and potentially complex presentations of mitral annular calcification.
More Related Videos
Related Concept Videos
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:27Mitral Valve Prolapse I: Introduction
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
01:26Mitral Stenosis III: Medical Management
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
01:22Mitral Valve Prolapse II: Assessment and Management
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
01:25Mitral Regurgitation III: Medical Management
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...