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Decalcification of the mitral annulus: surgical experience in 81 patients

M Dietrich1, M Doss, T Aybek

  • 1JWG Universitätsklinik Frankfurt am Main, THG-Chirurgie, Frankfurt am Main, Germany. md.md@gmx.de

The Thoracic and Cardiovascular Surgeon
|November 8, 2006
PubMed

Insights

Mitral annulus decalcification during valve surgery is challenging but feasible. This procedure, despite risks, yields good clinical outcomes for patients with severe mitral annular calcification.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Disease
  • Mitral Valve Repair and Replacement

Background:

  • Extensive mitral annular calcification (MAC) presents significant technical challenges in mitral valve surgery.
  • MAC increases perioperative risks, complicating both mitral valve repair and replacement procedures.

Purpose of the Study:

  • To review the clinical experience and outcomes of mitral valve surgery involving decalcification of the mitral annulus.
  • To assess the feasibility and efficacy of decalcification in patients with extensive MAC undergoing mitral valve reconstruction or replacement.

Main Methods:

  • Retrospective analysis of 81 patients (mean age 64 years) with extensive MAC undergoing mitral valve repair or replacement between 1995 and 2003.
  • Procedures included mitral valve repair (n=42), biological replacement (n=20), and mechanical replacement (n=19).
  • Mean follow-up was 24 months, with a mean EuroSCORE of 7; 62% had concomitant procedures.

Main Results:

  • High perioperative survival (97.5%) and hospital survival (91.3%) were observed.
  • Two-year survival was 88.9%, with 90.2% freedom from reoperation.
  • Complications included reexploration for bleeding (n=8) and prolonged mechanical ventilation (n=5); no perioperative strokes occurred.

Conclusions:

  • Mitral valve surgery with decalcification of the mitral annulus can be performed successfully in patients with extensive calcification.
  • Despite elevated perioperative risks and potential need for reoperation, the procedure offers good clinical results.
  • This approach provides a viable option for managing complex mitral valve disease associated with severe MAC.
Abstract

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