Cardiovascular Imaging Asia 2024;8(4):77-80

doi:10.22468/cvia.2024.00080

Massive Left Atrial Calcification in Severe Long-Standing Mitral Stenosis Due to Rheumatic Heart Disease: A Case Report

Celly Anantaria ATMADIKOESOEMAH 1 ; Elen ELEN ; Wincent Candra DIWIRYA ; Bagus HERLAMBANG ; Sony Hilal WICAKSONO ; Manoefris KASIM ; Amiliana Mardiani SOESANTO

Affiliations

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Country

Republic of Korea

Language

English

Abstract

Massive calcification of the left atrium (LA), known as coconut atrium or porcelain atrium, is rare. This study emphasized the importance of assessing the extent of calcification in the LA before surgery. We present a case of a 55-year-old woman with severe, long-standing rheumatic mitral stenosis complicated by massive LA calcification. Mitral valve replacement surgery and thrombus evacuation were performed. Calcified LA complicates management, particularly in determining the surgical incision site, and alters atrial wall hemostatic properties while increasing right ventricular afterload. Available diagnostic modalities allow comprehensive preoperative planning for left atrial calcification. These methods identify specific case concerns and variations to optimize outcomes.