title: Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism and management implications.
abstract: We report a case of massive posterior mitral annular calcification causing severe systolic anterior motion of the anterior mitral leaflet and dynamic left ventricular outflow tract obstruction. Mechanism of genesis of systolic anterior motion by this unusual mechanism is illustrated. Importance of recognizing this mechanism and its implications for surgical therapy are discussed. Our patient also had liquefaction necrosis of mitral annular calcification causing its extension into left ventricular myocardium mimicking a tumor.
authors.affiliation: Division of Cardiovascular Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Poonam
authors.initials: P
authors.lastname: Puri
authors.forename: Radha
authors.initials: R
authors.lastname: Sarma
authors.forename: Enrique L
authors.initials: EL
authors.lastname: Ostrzega
authors.forename: Padmini
authors.initials: P
authors.lastname: Varadarajan
authors.forename: Ramdas G
authors.initials: RG
authors.lastname: Pai
mesh_terms: D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D001026:Coronary Artery Bypass; D003937:Diagnosis, Differential; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control