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Brian D. Powell, MD, David R. Holmes, MD, Rick A

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1 Calcium Embolism of the Coronary Arteries After Percutaneous Mitral Balloon Valvuloplasty 
Brian D. Powell, MD, David R. Holmes, MD, Rick A. Nishimura, MD, Charanjit S. Rihal, MD  Mayo Clinic Proceedings  Volume 76, Issue 7, Pages (July 2001) DOI: / Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

2 Figure 1 Case 1. Transseptal catheterization with double-balloon inflation across the stenotic mitral valve. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

3 Figure 2 Case 1. Angiogram showing a filling defect in the left main coronary artery with minimal contrast dye passing beyond the obstructing lesion. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

4 Figure 3 Case 1. Gross autopsy photographs. Left, Mitral valve viewed from left atrial aspect showing presumed source of embolus from exposed calcium near the posteromedial commissure (arrow). AML = anterior mitral leaflet. Right, Unroofed left main coronary artery at the bifurcation of the left anterior descending and circumflex arteries showing occlusion by a large calcific embolus (arrow). Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

5 Figure 4 Case 2. Left, Short-axis image of transthoracic echocardiogram showing a large protruding area of mitral valvular calcification, approximately 8 mm in diameter, along the medial commissure. Right, Artist representation of echocardiographic image. AML = anterior mitral leaflet; C = calcification; PML = posterior mitral leaflet. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

6 Figure 5 Case 2. Angiogram showing occlusion of the obtuse marginal artery. Mayo Clinic Proceedings  , DOI: ( / ) Copyright © 2001 Mayo Foundation for Medical Education and Research Terms and Conditions

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