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Annales de medecine interne 1981

[Calcifications of the mitral valve ring. A clinico-pathological study of 14 cases (author's transl)].

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M C Vacher-Lavenu
G Perrier-Santelli
J Fouchard
R Abelanet
M Degeorges

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Resumo

This study of 14 cases, found in 130 autopsies of people died in a Department of Cardio-vascular diseases, emphasizes the frequency of this lesion (10 p. 100) often ignored. Elderly people over 75 years are affected and twice more female than male. Grossly, this abnormality, responsible of a constant mitral insufficiency, is in the posterior cusp attachment at the junction with the ventricular wall. The atrial surface and the line of cusp apposition, commissures and chordae are respected. The main lesions associated with it are left ventricular hypertrophy, coronary and systemic atherosclerosis and most often aortic degenerative calcification, described by Monckeberg, in 50 p. 100 cases. Microscopically, calcifications are surrounded by fibrosis with non specific moderate inflammatory changes. Clinically mitral ring calcification must be searched in case of conduction disturbances of systolic murmurs by left anterior oblique radiography and above all by echocardiography. Except conduction disturbances, complications are infrequent and only seen in advanced lesions. No abnormality of calcium or lipid metabolisms is noted. In agreement with other studies, this one emphasizes the usefulness of echocardiographic diagnosis and the necessity to separate this geriatric entity from advanced post rheumatoid type lesions.

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