Long‐term results after reconstruction of a new annulus in heavily calcified mitral annulus

Abstract

Background and Aim of the Study In 2009 our group described a new surgical technique for patients with severe mitral valve calcification undergoing mitral valve surgery. This technique creates a new mitral annulus with plication of the mitral leaflet and the atrial wall. Our objective is to report the long‐term results of the experience at our institution. Materials, Methods, and Results From 2007 to 2016, a total of 18 patients (mean age 70.5 ± 7.8 years) underwent mitral valve replacement at our institution with this technique. One patient died on the second postoperative day. Clinical and echocardiographic in‐hospital and long‐term follow‐up (55.5 ± 40.4 months) were performed on all the remaining 17 patients. Functional improvement was achieved in all patients. Two patients died 6 and 8 years after surgery (cancer and hemorrhagic stroke). No prosthetic dysfunction, periprosthetic leak, or annular dehiscence were detected in the long‐term echocardiographic examinations. Conclusions The reconstruction of the mitral annulus by using our technique in patients with severe calcification of the mitral annulus has low long‐term mortality, good functional results, and a lack of prosthetic complications.

Contemporary Surgical and Transcatheter Management of Mitral Annular Calcification

“…The group reported 55-month follow-up on 18 patients: 1 patient died on day 2, and another 2 patients died 6 and 8 years after the surgical procedure. 37 There were no cases of PVR, and all patients were in New York Heart Association functional class I or II.…”

Outcomes of mitral valve replacement with complete annular decalcification

“…8 Di Stefano et al presented a satisfactory long-term outcome of a technique that creates a new annulus with a plicated mitral leaflet and atrial wall. 3 However, this technique has the problem of being forced to implant a much smaller prosthesis than desired. In recent years, transcatheter MVR in MAC has emerged as an option for patients at high risk for surgical MVR.…”

“…Some conservative approaches in which mitral valve surgery is performed without touching MAC have been described with good long-term results. 3,4 However, these techniques can be adopted only in patients who meet certain conditions due to the problems inherent to each method.…”

Mitral valve surgery with extensive annular calcification: review of surgical techniques and postoperative complications

“…Forty full-text articles were assessed for eligibility. Twenty-five articles [5][6][7][14][15][16][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] met our inclusion criteria with a total of 1327 patients. The studies were published from 1986 to 2020, and the sample size ranged from 11 to 124.…”