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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Mitral Annular Calcification in Obstructive Hypertrophic Cardiomyopathy: Prevalence and Outcomes.
Sri Harsha Patlolla1, Hartzell V Schaff1, Rick A Nishimura2
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
The Annals of Thoracic Surgery
|November 25, 2021
Summary
Mitral annular calcification (MAC) is common in obstructive hypertrophic cardiomyopathy (HCM) and predicts poor survival after septal myectomy. This finding highlights the importance of assessing MAC in HCM patients undergoing surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Mitral annular calcification (MAC) prevalence and impact in obstructive hypertrophic cardiomyopathy (HCM) are understudied.
- Obstructive HCM affects left ventricular outflow tract, often requiring surgical intervention.
Approach:
- Retrospective review of 2113 patients undergoing septal myectomy.
- Analysis of echocardiograms and operative notes to identify MAC.
- Kaplan-Meier and Cox regression analyses for survival and mortality predictors.
Key Points:
- MAC identified in 18.5% of patients, associated with older age and female sex.
- MAC linked to higher resting LVOT gradients, preoperative mitral regurgitation, and mitral valve replacement rates.
- MAC independently predicted poor survival post-septal myectomy (HR 1.46, P = .014).
Conclusions:
- MAC is a frequent comorbidity in obstructive HCM, particularly in older females.
- MAC is associated with increased need for mitral valve intervention during septal myectomy.
- Despite comorbidities, MAC independently predicts mortality after septal myectomy in HCM patients.
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