{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T10:52:33Z","timestamp":1774954353402,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T00:00:00Z","timestamp":1516233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>Caseous calcification of the mitral annulus (<jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content>) is considered a rare variant of mitral annular calcification (<jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>) due to caseous transformation of the inner material and prevalence of <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content>, about 0.63% of all <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> cases and 0.06%\u20130.07% of the population. The precise pathophysiology of <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content> is still unknown. It is a chronic degenerative disorder common in the elderly, particularly in women. Caseous calcification of the mitral annulus (<jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content>) is a soft peri\u2010annular extensive calcification, resembling cardiac tumors, abscesses, vegetation, or calcified thrombus, which is composed of an admixture of calcium, fatty acids, and cholesterol with a toothpaste\u2010like texture. In the characteristic appearance on echocardiography, the calcification is a round, large, soft mass with a central echo dense area, typically located at the basal area of the posterior mitral valve. It usually carries a benign prognosis but rarely may be complicated with mitral valve dysfunction (valve stenosis\/mitral regurgitation) or systemic embolization. The current data suggest conservative medical therapy and clinical follow\u2010up for management of <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content> unless there is a need of cardiac surgery for severe mitral stenosis and\/or regurgitation. We present a case, complicated with severe mitral regurgitation, and need surgical resection of the <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content> because of the <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content>\u2010induced symptomatic severe mitral regurgitation despite optimal medical therapy. Macroscopic and microscopic examination of caseous material also demonstrated the characteristic appearance of <jats:styled-content style=\"fixed-case\">CCMA<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/echo.13800","type":"journal-article","created":{"date-parts":[[2018,1,18]],"date-time":"2018-01-18T17:23:37Z","timestamp":1516296217000},"page":"282-284","source":"Crossref","is-referenced-by-count":6,"title":["An extensive caseous calcification of the mitral annulus complicated with severe mitral regurgitation"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-395X","authenticated-orcid":false,"given":"Alper","family":"Karakus","sequence":"first","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Tibilli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim H.","family":"Inanc","sequence":"additional","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Tasolar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serdar","family":"Turkmen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erdal","family":"Akturk","sequence":"additional","affiliation":[{"name":"Department of Cardiology Faculty of Medicine Adiyaman University  Adiyaman Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,18]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22199"},{"key":"e_1_2_3_3_1","first-page":"427","article-title":"Atypical mitral annular calcification mimicking an intracardiac tumor","volume":"35","author":"T\u00fcrk U\u00d6","year":"2007","journal-title":"T\u00fcrk Kardiyol Dern Ars"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2009.00933.x"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12033"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2010.01321.x"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2010.01315.x"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.12968\/hmed.2013.74.12.697"},{"key":"e_1_2_3_9_1","first-page":"828","article-title":"Caseous calcification of the mitral annulus, a rare echocardiographic finding","volume":"64","author":"Garc\u00eda\u2010Ibarrondo N","year":"2011","journal-title":"Rev Esp Cardiol"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/echo.12109"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2007.12.004"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1159\/000326850"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fecho.13800","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.13800","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T16:25:34Z","timestamp":1695572734000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.13800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,18]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1111\/echo.13800"],"URL":"https:\/\/doi.org\/10.1111\/echo.13800","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,18]]}}}