Mitral Annular Calcification-Related Valvular Disease: A Challenging Entity

Area of Science:

• Cardiovascular Medicine
• Cardiac Surgery
• Interventional Cardiology

Background:

• Mitral valve annular calcification (MAC) is a growing concern, particularly in aging populations.
• MAC significantly impacts mitral valve structure and function, potentially causing regurgitation, stenosis, or both.
• Coexisting conditions and overlapping symptoms complicate the diagnosis and management of MAC-related valvular disease.

Purpose of the Study:

• To review the pathophysiology of mitral valve disease stemming from mitral annular calcification.
• To outline diagnostic strategies for assessing mitral annular calcifications and related valve dysfunction.
• To discuss current and emerging therapeutic options for mitral annular calcification-related valvular disease.

Main Methods:

• Review of current literature on mitral annular calcification and associated valvular pathologies.
• Emphasis on diagnostic modalities including two-dimensional echocardiography, multidetector computed tomography, and three-dimensional echocardiography.
• Discussion of invasive hemodynamic testing and the role of transcatheter interventions.

Main Results:

• Mitral annular calcification alters the mitral valve annulus, leading to significant valvular dysfunction.
• Accurate assessment of mitral regurgitation and stenosis requires a combination of imaging techniques.
• Transcatheter interventions are a promising therapeutic avenue for elderly patients.

Conclusions:

• Mitral annular calcification-related valvular disease presents complex diagnostic and therapeutic challenges.
• Multimodality imaging is crucial for comprehensive patient evaluation.
• Management strategies encompass both traditional surgical approaches and modern transcatheter interventions.