title: Surgical Management of Caseous Calcification of the Mitral Annulus.
abstract: Caseous calcification of the mitral annulus is a rare variant of mitral annular calcification where liquefaction and caseation result in formation of a mass at the border of the calcified annulus. Limited reports of operative therapy for caseous calcification of the mitral annulus describe wide excision and gross débridement of the mass, a technique that can cause perioperative stroke. We present a strategy of limited incision and drainage of the liquid material, closure of the incision, and subsequent suture obliteration of the cavity and mitral valve repair or replacement. In our experience, this technique is safe and has not been associated with perioperative stroke.
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Brody
authors.initials: B
authors.lastname: Wehman
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Dawood
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Ghoreishi
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Faisal
authors.initials: F
authors.lastname: Cheema
authors.affiliation: Department of Pharmaceutical Sciences, University of Maryland School of Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland.
authors.forename: Jace W
authors.initials: JW
authors.lastname: Jones
authors.affiliation: Department of Pharmaceutical Sciences, University of Maryland School of Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Kane
authors.affiliation: Department of Physiology, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Ward
authors.affiliation: Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland. Electronic address: jsgammiemd@gmail.com.
authors.forename: James S
authors.initials: JS
authors.lastname: Gammie
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed