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Massive Left Atrial Calcification Associated with Mitral Valve Replacement

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초록

The left atrial (LA) calcification is a relatively uncommon complication of long-standing rheumatic valvular heart disease.1) Completed calcification of LA has been described as a ‘coconut atrium’2)3) or ‘porcelain atrium’.4)5) Porcelain atrium involves the LA appendage, the free wall of the LA and the mitral valve apparatus, except interatrial septum, whereas coconut atrium involves all areas of the LA.2-5) Porcelain atrium or coconut atrium is rare disease entity, furthermore the massive calcification of LA after mitral valve replacement has been reported very few the cases.6)7)Authors experienced a 67-year-old woman who had massive LA calcification after mitral valve replacement. Therefore,we report this case with review of literature.

Abstract

The left atrial (LA) calcification is a relatively uncommon complication of long-standing rheumatic valvular heart disease.1) Completed calcification of LA has been described as a ‘coconut atrium’2)3) or ‘porcelain atrium’.4)5) Porcelain atrium involves the LA appendage, the free wall of the LA and the mitral valve apparatus, except interatrial septum, whereas coconut atrium involves all areas of the LA.2-5) Porcelain atrium or coconut atrium is rare disease entity, furthermore the massive calcification of LA after mitral valve replacement has been reported very few the cases.6)7)Authors experienced a 67-year-old woman who had massive LA calcification after mitral valve replacement. Therefore,we report this case with review of literature.

참고문헌 (16)

  1. Vallejo JL, "Massive calcification of the left atrium: surgical implications", Ann Thorac Surg, 60, pp.1226~1229 (1995)
  2. Meyners W, "A coconut left atrium 23 years after mitral valve replacement for chronic mitral stenosis", Z Kardiol, 92, pp.82~83 (2003)
  3. Del Campo C, "Coconut atrium: transmural calcification of the entire left atrium", Tex Heart Inst J, 27, pp.49~51 (2000)
  4. Edwards JM, "Porcelain atrium: rheumatic heart disease", Can J Cardiol, 22, pp.267~ (2006)
  5. Ha JW, "Porcelain atrium", Clin Cardiol, 24, pp.484~ (2001)
  6. Lin YS, "Massive left atrial and interatrial septal calcification after mitral valve replacement", Chin Med J, 121, pp.1497~1499 (2008)
  7. 소영호, "승모판 치환 후 좌심방 벽 석회화: 전산화 단층 촬영소견 및 임상적 의의", 대한영상의학회지, 47(6), pp.607~613 (2002), 대한영상의학회
  8. Oppenheimer BS, "Calcification and osteogenic change of the left auricle in a case of auricular fibrillation", Proc NY Pathol Soc, 12, pp.213~215 (1912)
  9. Harthorne JW, "Left atrial calcification. Review of literature and proposed management", Circulation, 34, pp.198~210 (1966)
  10. Koroglu M, "Left atrial, pulmonary vein and dural calcification in a patient with arrhythmia and chronic renal failure", JBR-BTR, 88, pp.78~79 (2005)
  11. Lahey T, "Massive left atrial calcification and devastating systemic emboli in a patient with chronic renal failure", Am J Kidney Dis, 40, pp.416~419 (2002)
  12. Peces R, "Left atrial calcification in a hemodialysis patient with cor triatriatum", Am J Kidney Dis, 35, pp.E27~ (2000)
  13. 김성훈, "좌심방 석회화와 관련된 반복된 좌심방 혈전 1예", Korean Circulation Journal, 34(3), pp.323~327 (2004), 대한심장학회
  14. Roberts WC, "Giant right atrium in rheumatic mitral stenosis. Atrial enlargement restricted by mural calcification", Am Heart J, 79, pp.28~35 (1970)
  15. Vilacosta I, "Massive left atrial calcification: a limitation of transesophageal echocardiography", Am Heart J, 127, pp.461~463 (1994)
  16. Goel AK, "Transesophageal echocardiography in the presence of left atrial calcification", J Am Soc Echocardiogr, 10, pp.677~679 (1997)

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