Diagnosis, Classification, and Management Strategies for Mitral Annular Calcification: A Heart Valve Collaboratory Position Statement.

Gorav Ailawadi, Isaac George, Martin B Leon, Michael J Mack, Vinayak Bapat, Vinod H Thourani, Tsuyoshi Kaneko, Mackram F Eleid, Philipp Blanke, D Scott Lim, Mayra E Guerrero, Gilbert H L Tang, João Cavalcante, David Blusztein, Yousif Ahmad, Dee Dee Wang, Paul Sorajja, Robert L Smith, Paul Grayburn

Journal: JACC. Cardiovascular interventions 2023;16(18):2195-2210

PMID: 37758378

Free Full Text on Elsevier Science View on PubMed

Abstract

Mitral annular calcium (MAC) with severe mitral valvular dysfunction presents a complex problem, as valve replacement, either surgical or transcatheter, is challenging because of anatomy, technical considerations, concomitant comorbidities, and advanced age. The authors review the clinical and anatomical features of MAC that are favorable (green light), challenging (yellow light), or prohibitive (red light) for surgical or transcatheter mitral valve interventions. Under the auspices of the Heart Valve Collaboratory, an expert working group of cardiac surgeons, interventional cardiologists, and interventional imaging cardiologists was formed to develop recommendations regarding treatment options for patients with MAC as well as a proposed grading and staging system using both anatomical and clinical features.

Address: Mayo Clinic, Rochester, Minnesota, USA. Electronic address: [email protected].; Baylor Scott & White Health, Plano, Texas, USA.; Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.; Henry Ford Health, Detroit, Michigan, USA.; Yale University School of Medicine, New Haven, Connecticut, USA.; Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York, USA.; Mount Sinai Health System, New York, New York, USA.; University of Michigan, Ann Arbor, Michigan, USA.; University of Virginia, Charlottesville, Virginia, USA.; St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.; Mayo Clinic, Rochester, Minnesota, USA.; Washington University School of Medicine, St. Louis, Missouri, USA.; Piedmont Heart Institute, Atlanta, Georgia, USA.

DOI: 10.1016/j.jcin.2023.06.044

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MeSH Terms: Humans, Mitral Valve, Heart Valve Prosthesis Implantation, Treatment Outcome, Heart Valve Diseases, Heart Valve Prosthesis, Calcinosis, Cardiac Catheterization, Mitral Valve Insufficiency