[HSF] Curious mitral lesion

[Hgrmd at aol.com]

Mark,
  I've seen an identical lesion in 2 patients.  The last one was  about 8 
years ago.  Both were in the P2 area.  The first one I saw, I  merely drained the 
lesion as you did and the patient came back with MR probably  5 years later.  
I ended up replacing the valve.  On the 2nd case, I  temporarily detached the 
posterior leaflet, unroofed the collection, and then  covered it with 
autologous pericardium. She did well and was eventually  lost to followup.
  I've no idea what this sterile goop is, but suspect this is a  variant of 
the process producing calcification of the posterior annulus.   Instead of a 
hard plaque, it is soft and cheesy.  Quite honestly, I  doubt an unruptured 
collection would produce embolization, and suspect  your patient had another cause 
for the stroke.
 
Hal
   



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