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Implantation of Transcatheter Aortic Prosthesis in 3 Patients With Mitral Annular Calcification

Heike Baumgarten1, John J Squiers1, William T Brinkman2

  • 1Baylor, Scott & White Research Institute, Dallas, Texas.

The Annals of Thoracic Surgery
|October 25, 2016
PubMed

Insights

Severe mitral annular calcification (MAC) poses surgical risks. A novel technique using an inverted transcatheter aortic valve enabled successful mitral valve replacement in three patients with severe circular MAC.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Mitral annular calcification (MAC) is a degenerative process impacting the mitral valve's fibrous base.
  • Severe MAC presents significant challenges and risks during mitral valve operations, including atrioventricular disruption and circumflex artery injury.
  • Traditional surgical approaches for severe MAC can be complex and associated with adverse events.

Observation:

  • This report details a series of three consecutive female patients diagnosed with severe circular MAC.
  • These patients underwent mitral valve replacement via a lateral minithoracotomy approach.
  • An inverted transcatheter aortic valve was utilized in the procedure.

Findings:

  • Successful mitral valve replacement was achieved in all three patients with severe circular MAC.
  • The use of an inverted transcatheter aortic valve facilitated the procedure despite the challenging calcification.
  • The lateral minithoracotomy approach proved effective for this complex surgical scenario.

Implications:

  • This case series suggests a potential new strategy for managing patients with severe, complex mitral annular calcification.
  • The utilization of an inverted transcatheter aortic valve may offer a viable alternative in challenging mitral valve surgeries.
  • Further research is warranted to explore the broader applicability and long-term outcomes of this innovative surgical technique.

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