Kato Mahoto, Nakatani Satoshi, Okazaki Hidetoshi, Tagusari Osamu, Kitakaze Masafumi
Departments of Cardiology and Cardiothoracic Surgery, National Cardiovascular Center, Osaka, Japan.
Cardiology. 2006;106(3):164-6. doi: 10.1159/000092827. Epub 2006 Apr 24.
Although mitral annular calcification (MAC) is usually easy to diagnose by transthoracic echocardiography, we experienced a rare case with MAC which looked like an intracardiac tumor. The patient who had been on chronic hemodialysis for 20 years was admitted to our hospital because of dyspnea. Transthoracic echocardiography showed a mass with severe calcification on the anterior mitral annulus and mean mitral gradient of 20 mm Hg. Because of the suspicion of the intracardiac calcified tumor that restricted mitral valve motion causing mitral obstruction, she underwent resection of the mass and mitral valve replacement. Pathological findings showed that the mass had a calcified envelope containing liquefied necrotic eosinophilic material with lympocytic infiltrate inside consistent with MAC. We should consider a possibility of MAC when we see a severe calcified mass attached to the mitral annulus in a patient on long-term hemodialysis.
虽然二尖瓣环钙化（MAC）通常通过经胸超声心动图很容易诊断，但我们遇到了一例罕见的MAC病例，其表现类似心内肿瘤。该患者长期接受慢性血液透析20年，因呼吸困难入住我院。经胸超声心动图显示二尖瓣前环有一个严重钙化的肿块，二尖瓣平均压差为20 mmHg。由于怀疑是心内钙化肿瘤限制二尖瓣活动导致二尖瓣梗阻，她接受了肿块切除及二尖瓣置换术。病理结果显示，肿块有一个钙化包膜，内含液化坏死的嗜酸性物质，内部有淋巴细胞浸润，符合MAC表现。当我们在长期血液透析患者中看到附着于二尖瓣环的严重钙化肿块时，应考虑MAC的可能性。
