Refined Approach to the Treatment of Caseous Calcification of the Mitral Annulus: A Case Report

Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification (MAC), in which the core of the calcification undergoes a caseous transformation. CCMA can cause dysfunction of the mitral valve or embolization of caseous material, requiring surgery. There is currently no clear consensus on the optimal treatment strategy for CCMA. Attempts to address the condition, including surgical removal of calcification or mitral valve replacement, have faced certain challenges. This case details a refined approach consisting of partial debridement of the calcification and subsequent annular reconstruction with a bovine pericardial patch prior to surgical valve replacement.