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Mitral Annulus Calcium Score.

Yafim Brodov1,2, Eli Konen2, Mattia Di Segni2

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Summary
This summary is machine-generated.

Mitral annular calcium (MAC) score predicts conduction system abnormalities (CSA) after transcatheter aortic valve implantation. High MAC scores indicate increased risk for CSA, necessitating closer patient monitoring.

Keywords:
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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • Transcatheter aortic valve implantation (TAVI) carries a risk of conduction system abnormalities (CSA).
  • Mitral annular calcium (MAC) is a potential factor influencing CSA development post-TAVI.

Purpose of the Study:

  • To assess the predictive value of MAC score for CSA after TAVI.
  • To identify patients at higher risk for CSA following TAVI.

Main Methods:

  • 168 patients with severe aortic stenosis underwent TAVI (CoreValve or SAPIEN).
  • Mitral annular calcium, aortic valve, and left ventricular outflow tract calcium scores were quantified using computed tomography.
  • Primary endpoint: complete left bundle branch block or high-degree atrioventricular block.

Main Results:

  • Patients in the highest MAC score quartile (>2700) had a significantly higher incidence of the primary endpoint (62%) compared to the lowest quartile (<140) (31%).
  • MAC score was an independent predictor of CSA, both as a continuous variable and by quartile.
  • The fourth MAC score quartile was a strong independent predictor of CSA (OR: 3.69).

Conclusions:

  • MAC score is an independent predictor of CSA in TAVI patients without prior conduction abnormalities.
  • Patients with high MAC scores (fourth quartile) are at increased risk for CSA post-TAVI.
  • High MAC score identifies patients requiring closer monitoring after TAVI.