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Caseous calcification of the mitral annulus (CCMA) is a very rare form of mitral annular calcification (MAC). CCMA accounts for 0.63% of all cases and 0.06-0.07% of the total population and usually seen in elderly and female patients. It mostly affects the posterior leaflet of the mitral valve. The pathogenesis of CCMA remains unclear. Hypercholesterolemia and the dissolution of lipid-laden macrophages may be implicated in liquefaction necrosis. CCMA is composed of a mixture of calcium, fatty acid, and cholesterol. The name "caseous" comes from the cheese-like or toothpaste-like consistency of the mass. Cardiac magnetic resonance imaging may help in differentiating MAC from CCMA and should perform. The first treatment option should be conservative treatment because of surgical complications of the procedure. We presented a case report which is about CCMA with preoperative and intraoperative robotic images., (© 2020 Wiley Periodicals, Inc.)

The article presents case study of 74-year-old female with ischemic heart failure with New York Heart Association class III dyspnea. It mentions association of Dilated cardiomyopathy (DCM) with variable degrees of functional mitral regurgitation (FMR); and also mentions CARILLON Mitral Contour System, an approach using the anatomical proximity of the coronary sinus (CS) to the mitral annulus.