Imaging of Caseous Mitral Annulus Calcification.

We present 2 cases of caseous mitral annulus calcification (MAC) in which one patient was asymptomatic whereas the second experienced left hemianopsia. Both patients underwent transthoracic and transesophageal echocardiography exams which revealed severe MAC with a mass consistent with caseous MAC. A mobile component of the caseous MAC was observed in the patient with left hemianopsia. Cardiac computerized tomography angiography confirmed the diagnosis. Considering the high surgical risk of caseous MAC debridement, both patients were treated conservatively with uneventful clinical follow-up.