Bacterial Endocarditis on Calcification of the Mitral Anulus Fibrosus

Abstract

The clinical and autopsy findings in seven patients with bacterial endocarditis superimposed on degenerative calcification of the anulus fibrosus of the mitral valve are described. The calcification, with resultant deformity of the mitral valve, probably predisposed these patients to infection. The endocarditis was unusual in its location at the base of the valve and in its extension into the calcified ring and adjacent myocardium. The infection involved the posterior mitral leaflet in six patients and the anterior leaflet in one. In all cases the involved leaflet was perforated by the sepsis. The nature of this infection makes it unlikely that it is curable with either antibiotics or cardiac surgery. It is strongly recommended that appropriate endocarditis antibiotic prophylaxis be accorded all elderly patients with calcification of the mitral anulus.