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Transcatheter mitral valve implantation in severe mitral annular calcification: a case report

Giulio Russo1, Valerio Maffi1, Gianluca Massaro1

  • 1Department of Biomedicine and Prevention, Cardiology Unit, Policlinico Tor Vergata, University of Rome, 00100 Rome, Italy.

European Heart Journal. Case Reports
|January 3, 2025
PubMed

Insights

Mitral annular calcification (MAC) presents significant challenges for treatment. This case report details a successful valve-in-MAC procedure for severe mitral steno-insufficiency, highlighting the importance of careful planning.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Mitral annular calcification (MAC) involves severe calcification of the mitral annulus, often leading to mitral regurgitation and stenosis.
  • MAC poses significant technical challenges for both surgical and percutaneous interventions, associated with high mortality rates.

Observation:

  • A case report of an 83-year-old female with severe mitral steno-insufficiency secondary to MAC.
  • The patient presented with comorbidities and a history of prior surgeries, deeming her unsuitable for conventional surgery.
  • A percutaneous valve-in-MAC procedure was chosen, requiring a subsequent plug implantation to address a paravalvular leak.

Findings:

  • Transcatheter mitral valve implantation in MAC is a viable alternative to surgery, despite technical difficulties and risks.
  • Successful management of complex mitral steno-insufficiency in a high-risk patient with MAC was achieved through a percutaneous approach.

Implications:

  • This case underscores the feasibility of valve-in-MAC procedures for complex mitral valve disease in elderly patients with comorbidities.
  • Meticulous procedural planning is crucial for optimizing outcomes in transcatheter mitral valve interventions for MAC.
  • Percutaneous treatment offers a potential solution for patients with MAC who are not candidates for traditional surgery.
Abstract

Keywords:
Case reportMitral annular calcificationMitral regurgitationMitral stenosisTranscatheter mitral valve implantationValve-in-MAC

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