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Management of Patients With Severe Mitral Annular Calcification: JACC State-of-the-Art Review

Omar Chehab1, Ross Roberts-Thomson2, Antonio Bivona1

  • 1Departments of Cardiology and Cardiac Surgery, St Thomas' Hospital, Westminster Bridge Road, London, United Kingdom.

Journal of the American College of Cardiology
|August 11, 2022
PubMed

Insights

Mitral annular calcification (MAC) presents challenges in heart valve surgery, particularly for aging populations. This review explores prognosis, planning, and management strategies for patients with MAC.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Geriatric Medicine

Background:

  • Mitral annular calcification (MAC) is a prevalent condition in aging populations.
  • Surgical intervention for mitral valve disease in patients with MAC is complex due to annular anatomy.
  • Transcatheter valve interventions offer new therapeutic avenues for MAC.

Purpose of the Study:

  • To review the current understanding of mitral annular calcification (MAC).
  • To discuss prognostic factors associated with MAC.
  • To outline preoperative planning and management strategies for MAC patients.

Main Methods:

  • This is a review article, synthesizing existing literature.
  • Focuses on prognostic data, imaging modalities, and treatment guidelines.
  • Emphasizes the role of advanced imaging in decision-making.

Main Results:

  • MAC poses significant challenges for surgical and transcatheter mitral valve interventions.
  • Advanced imaging is crucial for assessing MAC severity and guiding treatment.
  • A multidisciplinary heart team approach is essential for optimal patient management.

Conclusions:

  • Effective management of MAC requires a thorough understanding of its implications.
  • Preoperative planning and tailored strategies are vital for successful outcomes.
  • Ongoing research and technological advancements continue to improve treatment options for MAC.

Keywords:
mitral annular calcificationmitral valvesurgeryvalve-in-MAC

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