Reduced Size of Liquefaction Necrosis of Mitral Annular Calcification in Chronic Renal Failure by Using Low Calcium Concentration Hemodialysis

概要

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A report is presented of a liquefaction necrosis of mitral annular calcification in a patient with chronic renal failure and secondary hyperparathyroidism who hadbeen managed by hemodialysis for 11 years. The mass was echogenic with an echo-lucent area inside, high density on computed tomography and low intensity on magnetic resonance imaging. The uptake of gallium-67(^67Ga)-citrate and the bone agent technetium-99m-methylene diphosphate(^99mTc-MDP)was seen in the mass. These findings were compatible with liquefaction necrosis of the mitral annular calcification. After treatment with low calcium concentration hemodialysis, the size of the mass reduced with disappearance of the echo-lucent area on the echocardiography and there was no uptake of ^67Ga-citrate or ^99mTc-MDP. Liquefaction necrosis might be the early and reversible form of mitral annular calcification. When a tumorlike echogenic mass at the base of mitral leaflets is seen in patients with predisposing factors for mitral annular calcification, consider the possibility of this specific form of mitral annular calcification in order to avoid any unnecessary surgical intervention.
社団法人日本循環器学会の論文
1999-05-20