Related Experiment Video
Updated: Jan 27, 2026
08:43
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
20.3K
Mitral Annular Calcification and Calcific Mitral Stenosis: Therapeutic Challenges and Considerations
Philippe B Bertrand1, Christos G Mihos2, Evin Yucel3
1Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Yawkey 5E, Boston, MA, 02114, USA.
Current Treatment Options in Cardiovascular Medicine
|April 1, 2019
Summary
Mitral annular calcification (MAC) and calcific mitral stenosis (MS) present challenges in the aging population. While surgery is standard, transcatheter mitral valve replacement (TMVR) is being explored for high-risk patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Valvular Heart Disease
Background:
- Mitral annular calcification (MAC) and calcific mitral stenosis (MS) are increasingly prevalent in older adults.
- Optimal management and outcomes for these conditions remain a significant clinical challenge.
Purpose of the Study:
- To review diagnostic and therapeutic challenges in calcific mitral stenosis (MS).
- To discuss indications for valve intervention, procedural considerations, and novel treatment strategies.
Main Methods:
- Review of current literature and clinical trial data on MAC and MS management.
- Emphasis on multimodality imaging for patient selection.
Main Results:
- Surgical mitral valve replacement is the primary treatment for symptomatic patients with acceptable surgical risk.
- Transcatheter mitral valve replacement (TMVR) is under investigation for high-risk patients, facing technological hurdles and suboptimal outcomes.
- Multimodality imaging is crucial for optimizing patient selection.
Conclusions:
- Calcific mitral stenosis is a growing concern with poor prognoses.
- While surgical options exist, TMVR shows promise but requires further technological advancement and clinical evaluation.
- Minimizing risks like left ventricular outflow tract obstruction and paravalvular leakage is critical for future TMVR success.
Related Concept Videos
01:22Mitral Stenosis I: Introduction
573
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
573
01:27Mitral Stenosis IV: Nursing Management
273
A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
273
01:26Mitral Stenosis III: Medical Management
278
Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
278
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
251
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
251
01:27Mitral Valve Prolapse I: Introduction
452
IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
452
01:20Mitral Regurgitation I: Introduction
494
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
494