CTICasesMitral Valve Stenosis with Thrombus, Unroofed Coronary Sinus, Azygos Continuation, and Tracheal/Bronchial Calcification
Imaging findings
A mechanical mitral valve prosthesis shows a fixed anterior leaflet with a clear round filling defect at its base, consistent with thrombus causing mitral valve stenosis. There is an unroofed coronary sinus with contrast refluxing from the left atrium. Extensive tracheal and bronchial calcification is observed in this young patient, attributed to long-standing coumadin anticoagulation. Additionally, an interrupted inferior vena cava with azygos continuation is noted. The airways may also suggest bilateral hilar arterial bronchi.
Key takeaways
This case highlights multiple findings including mechanical mitral valve dysfunction due to thrombus, an unroofed coronary sinus, and tracheal/bronchial calcification as a potential side effect of chronic coumadin use. The presence of azygos continuation with an interrupted IVC further demonstrates complex congenital anomalies.
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