CTICasesAtrial Extension of Mitral Annular Calcification (MAC)
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Imaging findings
A TAVI planning CT scan demonstrates massive, florid calcifications centered at the mitral valve annulus that extend directly into the left atrium. The calcifications are surrounded by contrast medium, mimicking a lobulated, calcified intracardiac mass.
Key takeaways
Mitral annular calcification (MAC) is a common, typically benign degenerative process, but it can occasionally be extremely robust and extend directly into the left atrium. This unusual atrial extension can mimic an intracardiac tumor or caseous necrosis of the mitral annulus, and it is frequently seen in patients with chronic renal failure on dialysis.
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