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Calcific valvular aortic stenosis with and without mitral anular calcium.
C K Nair1, M H Sketch, I Ahmed
1Division of Cardiology, Creighton University School of Medicine, Omaha, Nebraska 68131.
The American Journal of Cardiology
|October 1, 1987
Summary
Mitral annular calcium (MAC) in patients with aortic stenosis (AS) is linked to more severe disease and poorer outcomes after aortic valve replacement. These patients are older, require more pacemakers, and have higher cardiac mortality.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Calcific valvular aortic stenosis (AS) is a common valvular heart disease.
- Mitral annular calcium (MAC) is frequently observed in patients with AS.
- The clinical significance of MAC in the context of AS and aortic valve replacement (AVR) requires further elucidation.
Purpose of the Study:
- To investigate the association between mitral annular calcium (MAC) and clinical characteristics and outcomes in patients undergoing isolated aortic valve replacement for calcific aortic stenosis (AS).
Main Methods:
- Retrospective analysis of 76 consecutive patients undergoing isolated AVR for calcific AS.
- Echocardiography was used to detect mitral annular calcium (MAC).
- Patient demographics, echocardiographic parameters, procedural data, and long-term follow-up (mean 3.8 years) were analyzed.
Main Results:
- Mitral annular calcium (MAC) was detected in 59% of patients.
- Patients with MAC were older, had more severe AS (higher gradients, smaller valve areas), and lower cardiac indexes compared to those without MAC.
- Permanent pacemaker implantation was required in 33% of patients with MAC versus 10% without (p<0.025).
- Cardiac mortality during follow-up was significantly higher in patients with MAC (27%) compared to those without MAC (7%) (p<0.025).
Conclusions:
- Mitral annular calcium (MAC) is associated with older age and more severe aortic stenosis (AS) in patients undergoing AVR.
- The presence of MAC increases the risk of permanent pacemaker implantation after AVR.
- MAC is a significant predictor of increased cardiac mortality following aortic valve replacement for AS.