Cardiac Calcifications in Adults with Congenital Heart Defects

Congenit Heart Dis. 2015 Sep-Oct;10(5):396-402. doi: 10.1111/chd.12243. Epub 2015 Jan 7.

Abstract

Objective: We investigated the type and extent of calcification in a series of heart specimens from adult congenital heart disease patients because recent autopsy observations suggested a high prevalence of calcification.

Design: We used computed tomography to examine seven heart specimens from adults (>18 years old) with a congenital heart defect collected with permission from the family during a recent 3-year period. Clinical data regarding diagnosis, history, and imaging studies were recorded. The 3D data sets were reviewed after reformatting as maximum intensity projection and volumetric renderings to determine the pattern and extent of calcium deposition.

Results: Five of the seven hearts had extensive calcifications in one or more of three patterns: atherosclerosis associated in the three oldest cases; surgery associated in four of five hearts that had undergone heart surgery; and myocardial calcification remote from surgical sites in two cases. Myocardial calcification was associated with regional dysfunction and was present in the three patients that died suddenly and unexpectedly.

Conclusion: Cardiac calcification was frequent in our series of heart specimens from adults with congenital heart defects, was often but not uniformly associated with prior surgery, and, in our small series, was associated with regional dysfunction and sudden death.

Keywords: Adult Congenital Heart Disease; Calcifications; Myocardium; Pericardium.

Publication types

  • Video-Audio Media

MeSH terms

  • Adult
  • Aged
  • Autopsy
  • Calcinosis / diagnostic imaging
  • Calcinosis / etiology*
  • Calcinosis / metabolism
  • Calcinosis / mortality
  • Calcinosis / physiopathology
  • Calcium / analysis
  • Cardiac Surgical Procedures / adverse effects
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / etiology*
  • Cardiomyopathies / metabolism
  • Cardiomyopathies / mortality
  • Cardiomyopathies / pathology
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / metabolism
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Coronary Vessels / chemistry
  • Coronary Vessels / diagnostic imaging
  • Female
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / mortality
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / surgery
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Myocardium / chemistry
  • Myocardium / pathology
  • Predictive Value of Tests
  • Prognosis
  • Radiographic Image Interpretation, Computer-Assisted
  • Registries
  • Risk Factors
  • Time Factors
  • Vascular Calcification / diagnostic imaging
  • Vascular Calcification / etiology*
  • Vascular Calcification / metabolism
  • Vascular Calcification / mortality
  • Vascular Calcification / physiopathology
  • Young Adult

Substances

  • Calcium