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Minimally Invasive Hybrid Approach to High Risk Mitral Disease With Severe Mitral Annular Calcification

Dominique de Waard1, Mahmoud Alukayli2, Jill Gelinas3

  • 1Division of Cardiac Surgery, Western University, London, Ontario, Canada; Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

The Canadian Journal of Cardiology
|May 17, 2020
PubMed

Insights

Severe mitral annular calcification (MAC) poses surgical challenges. A novel hybrid transcatheter mitral valve replacement technique offers a minimally invasive solution for complex cases.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Severe circumferential mitral annular calcification (MAC) presents significant challenges for traditional surgical mitral valve repair or replacement.
  • Existing transcatheter mitral valve replacement (TMVR) strategies face limitations due to MAC, including risks of annular fixation, paravalvular leak, and left-ventricular outflow tract obstruction.

Observation:

  • A patient with severe circumferential MAC requiring mitral valve intervention was treated with a novel approach.
  • This case involved a minimally invasive hybrid technique combining transcatheter and surgical elements.

Findings:

  • The described hybrid technique successfully addressed the complexities posed by severe circumferential MAC.
  • This approach facilitated transcatheter mitral valve replacement in a challenging anatomical context.

Implications:

  • This novel hybrid technique may offer a viable alternative for patients with severe MAC unsuitable for conventional surgery.
  • Further research and clinical evaluation are warranted to establish the safety and efficacy of this minimally invasive approach for MAC patients.

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