Mitral Valve Replacement for Mitral Stenosis Secondary to Massive Mitral Annular Calcium

Contemporary experience with the Commando procedure for anterior mitral anular calcification

“…During the last decade, importance of mitral anular calcification–related mitral valve dysfunction has gained attention. 11 , 12 , 34 It is an increasing cause of mitral valve disease in older western populations and is associated with poor prognosis. 12 Recent nuclear imaging studies also suggest that patients with mitral anular calcification have higher local calcific and inflammatory activities, which are associated with disease progression.…”

“… 35 Quantifying and grading this calcification using echocardiography and cardiac CT are of increasing importance. 11 , 12 , 34 Thus, a thorough assessment of surgical risk in such patients is essential for optimizing preoperative therapy and surgical results. 11 In evaluating the effect on survival of calcium score in our patients, burden of calcium did not have a negative association with survival after Commando operations; however, the intervalvular fibrosa calcium score was associated with lower survival among patients who underwent standard DVR without replacing the intervalvular fibrosa.…”

A case of severe mitral annular calcification treated with ultrasonic aspiration and mitral valve replacement through minimally invasive access

“…Interventional treatments are seldomly feasible in MAC, and surgery has a high risk of mortality. 1 Ultrasonic aspiration has been proposed as a possible way to enable mitral valve replacement (MVR) but was only reported in open surgical setting until now. We present the case of an 80-year-old female patient with severe mitral regurgitation and MAC ( Figure 1A–C , Supplementary material : Video Pre OP ).…”