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Mitral annular calcification

Andrea Colli, Erica Manzan, Audrius Aidietis, Kestutis Rucinskas, Eleonora Bizzotto, Laura Besola, Nicola Pradegan, Demetrio Pittarello, Vilius Janusauskas, Diana Zakarkaite, Agne Drasutiene, Arturas Lipnevicius, Bernhard C Danner, Horst Sievert, Laura Vaskelyte, Nalan Schnelle, Stefano Salizzoni, Massimo Marro, Mauro Rinaldi, Katarzyna Kurnicka, Kristof Wrobel, Mariano Ceffarelli, Carlo Savini, Davide Pacini, Gino Gerosa
OBJECTIVES: Transapical off-pump NeoChord repair is a novel minimally invasive surgical procedure to treat degenerative mitral valve regurgitation. The aim was to evaluate 1-year clinical results of the NeoChord procedure in a consecutive cohort of patients. METHODS: Between February 2013 and July 2016, 213 patients were enrolled in the NeoChord Independent International Registry. All patients presented severe mitral regurgitation due to flail/prolapse of 1 or both leaflets, and they all completed postoperative echocardiographic assessment up to 1 year...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Oliver J Liakopoulos
No abstract text is available yet for this article.
February 8, 2018: Journal of Thoracic and Cardiovascular Surgery
S Gasser, H Reichenspurner, E Girdauskas
BACKGROUND: Myxomatous mitral valve prolapse is a common cardiac abnormality. Morbus Barlow is characterized by excess myxomatous leaflet tissue, bileaflet prolapse or billowing, chordae elongation and annular dilatation with or without calcification. Extensive myxoid degeneration with destruction of the normal three-layered leaflet tissue architecture is observed histologically in such patients. Autosomal dominant inheritance with an age and sex-dependent expression has long been recognised...
February 27, 2018: BMC Cardiovascular Disorders
Mio Kasai, Motohiko Osako, Tomoyuki Tanino, Arafumi Maeshima
Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic cardiac tumor. The clinical features of cardiac CATs resemble those of other cardiac tumors that include symptoms related to obstruction or embolization. Cardiac CATs have been found in all chambers of the heart, but predominantly present in the left ventricle, mitral annulus, and mitral valve. Here we report an extremely rare case of CAT originating in the aortic valve cusp, which may be related to aortic annular calcification and aortic valve stenosis...
February 23, 2018: Annals of Thoracic Surgery
Su Wan Kim, Dong Seop Jeong, Kiick Sung, Wook Sung Kim, Young Tak Lee, Pyo Won Park
BACKGROUND AND AIM OF THE STUDY: We evaluated the early and long-term outcomes of mitral annular reconstruction (MAR) with pericardium during mitral valve replacement (MVR), and analyzed the risk factors associated with post-operative mortality. METHODS: Between May 1997 and April 2013, 78 consecutive patients underwent MVR with MAR. The indications for MAR were treatment for annular infection in native valve endocarditis (n = 23, 29.5%) or prosthetic valve endocarditis (n = 26, 33...
February 20, 2018: Journal of Cardiac Surgery
Valérie Lafrenière-Bessi, Maude Cameron-Gagné, Jean Perron, Marie-Hélène Lévesque, Maxime Laflamme, Éric Charbonneau, Siamak Mohammadi, Frédéric Jacques
Mitral valve replacement is technically challenging in the context of mitral annular calcification. A new surgical strategy is described that was used in a 71-year-old obese patient, where intraatrial prosthesis insertion and valve fixation into native uncalcified structures were performed without calcium debridement.
February 2018: Annals of Thoracic Surgery
Abdallah El Sabbagh, Mackram F Eleid, Jane M Matsumoto, Nandan S Anavekar, Mohammed A Al-Hijji, Sameh M Said, Vuyisile T Nkomo, David R Holmes, Charanjit S Rihal, Thomas A Foley
INTRODUCTION: Three-dimensional (3D) prototyping is a novel technology which can be used to plan and guide complex procedures such as transcatheter mitral valve replacement (TMVR). METHODS: Eight patients with severe mitral annular calcification (MAC) underwent TMVR. 3D digital models with digital balloon expandable valves were created from pre-procedure CT scans using dedicated software. Five models were printed. These models were used to assess prosthesis sizing, anchoring, expansion, paravalvular gaps, left ventricular outflow tract (LVOT) obstruction, and other potential procedure pitfalls...
January 23, 2018: Catheterization and Cardiovascular Interventions
Alper Karakus, Hakan Tibilli, Ibrahim H Inanc, Hakan Tasolar, Serdar Turkmen, Erdal Akturk
Caseous calcification of the mitral annulus (CCMA) is considered a rare variant of mitral annular calcification (MAC) due to caseous transformation of the inner material and prevalence of CCMA, about 0.63% of all MAC cases and 0.06%-0.07% of the population. The precise pathophysiology of CCMA is still unknown. It is a chronic degenerative disorder common in the elderly, particularly in women. Caseous calcification of the mitral annulus (CCMA) is a soft peri-annular extensive calcification, resembling cardiac tumors, abscesses, vegetation, or calcified thrombus, which is composed of an admixture of calcium, fatty acids, and cholesterol with a toothpaste-like texture...
February 2018: Echocardiography
Yoshihiro Aizawa, Toshiko Nakai, Yuki Saito, Koyuru Monno, Tomoyuki Morikawa, Rikitake Kogawa, Takumi Hatta, Takehiro Tamaki, Mahoto Kato, Munehito Arimoto, Shunji Osaka, Keishin Sunagawa, Xiao Yan Tang, Masashi Tanaka, Hiroyuki Hao, Atsushi Hirayama
We report the case of a 38-year-old woman who was admitted for acute cerebral infarction linked to a cardiac calcified amorphous tumor (CAT) and related mitral annular calcification (MAC). The cardiac mass was removed, and mitral valve replacement surgery was performed. Pathological examination revealed an amorphous accumulation of degenerating material within both lesions, indicating that build-up of calcium along the mitral annulus and subsequent rupture of the fibrotic tissue may be involved in the initiation and progression of CAT...
January 15, 2018: International Heart Journal
Jeremy J Thaden, Joseph F Malouf, Vuyisile T Nkomo, Sorin V Pislaru, David R Holmes, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge-to-edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip. METHODS AND RESULTS: Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics...
January 13, 2018: Journal of the American Heart Association
Júlia Karády, Ioannis Ntalas, Bernard Prendergast, Christopher Blauth, Steven Niederer, Pál Maurovich-Horvat, Ronak Rajani
There is considerable interest in transcatheter prosthetic valve treatment for mitral valve disease in high-risk individuals. Although the presence of mitral annular calcium (MAC) may provide an anchoring zone for such devices, results to date have been modest with reported technical failure rates approaching 30% in specialist centers. This in part relates to the risk of left ventricular outflow tract obstruction and device dislodgment but also to the lack of specific imaging guidelines to plan for such procedures...
January 4, 2018: Journal of Cardiovascular Computed Tomography
Philip Dingli, Herbert Felice, Adrian Mizzi, Stephen Montefort
Mitral annular calcification (MAC) is a common condition of the mitral valve apparatus. A case involving caseous calcification, a rare variant of MAC is presented. This variant which has a benign course can present as an intracardiac mass and needs to be differentiated from more sinister causes of calcified cardiac masses such as tumor, abscess, and infective vegetation. Often, this requires multimodality imaging with echocardiography, computed tomography, and magnetic resonance imaging. Features of caseous calcification of the mitral valve on these imaging modalities are reviewed as the associations and clinical features...
April 2017: Journal of Family Medicine and Primary Care
Shauna Wentzell, Vidhya Nair
We present a unique case of a 76-year-old female who had sudden cardiac death due to hemopericardium. Post mortem examination revealed infective endocarditis(IE) superimposing on mitral annulus calcification(MAC) leading to abscess formation, epicardial fistulation and hemopericardium. MAC is currently considered a relatively benign condition of the elderly [1], however evidence suggests there are severe consequences when these patients develop IE. With an aging population, this is likely to be a more frequent occurrence and should be considered in patients who present with bacteremia of unknown origin...
December 5, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Dee Dee Wang, Marvin H Eng, Adam B Greenbaum, Eric Myers, Michael Forbes, Patrick Karabon, Milan Pantelic, Thomas Song, Jeff Nadig, Mayra Guerrero, William W O'Neill
OBJECTIVE: Demonstrate proof-of-concept validation of a computed tomography (CT) computer-aided design prediction modeling tool to identify patients at risk for left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve replacement (TMVR). BACKGROUND: LVOT obstruction is a significant and even fatal consequence of TMVR. METHODS: From August 2013 to August 2017, 38 patients in 5 centers underwent TMVR with compassionate use of balloon-expandable valves for severe mitral valve dysfunction because of degenerative surgical mitral ring, bioprosthesis, or severe native mitral stenosis from to severe mitral annular calcification...
December 11, 2017: Catheterization and Cardiovascular Interventions
Darae Kim, Chi Young Shim, Young Jin Kim, Byung-Chul Chang
No abstract text is available yet for this article.
November 27, 2017: European Journal of Cardio-thoracic Surgery
Matthew F Gottbrecht, Michael Salerno, Gerard P Aurigemma
OBJECTIVE: We undertook this study of echocardiographic classification of diastolic function by three different algorithms to determine: (1) how frequently each algorithm classified patients and (2) how well the results agreed with one another. BACKGROUND: Several algorithms exist to grade diastolic function (DF), the Mayo Clinic scheme of Redfield et al (Mayo 2003) and the 2 ASE guideline documents of 2009 and 2016 (ASE 2009 and ASE 2016). METHODS: A total of 200 consecutive echocardiograms were retrospectively analyzed; mean age of patients 60...
January 2018: Echocardiography
Kentaro Ishizuka, Takao Hoshino, Kyomi Ashihara, Kenji Mruyama, Sono Toi, Satoko Mizuno, Yuka Shirai, Nobuhisa Hagiwara, Kazuo Kitagawa
BACKGROUND: This study investigated the associations of mitral and aortic valve calcification with complex aortic atheroma among patients with embolic stroke of undetermined source. METHODS: We included 52 consecutive patients (mean age 58.1 years; 75.0% male) with embolic stroke of undetermined source. Mitral annular calcification, aortic annular calcification, and aortic valve sclerosis were assessed by transthoracic echocardiography. Complex aortic atheroma was assessed by transesophageal echocardiography and was defined as plaque protruding greater than or equal to 4 mm into the lumen or with ulcerated or mobile components...
March 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Hisham Samir Roshdy, Mohammad Hassan Soliman, Ibtesam Ibrahim El-Dosouky, Soheir Ghonemy
BACKGROUND: Skin acts as a mirror to the internal state of the body. HYPOTHESIS: We tried to find the relation between skin aging parameters and the incidence of degenerative AV block. METHODS: This study included 97 patients divided into 2 groups; group D comprised 49 patients with advanced-degree AV block, and group C comprised the 48 matched control group. All were subjected to full history taking, thorough clinical examination, calculation of intrinsic skin aging score, and resting 12-lead surface electrocardiography (ECG)...
November 23, 2017: Clinical Cardiology
Marco B Ancona, Francesco Giannini, Antonio Mangieri, Damiano Regazzoli, Richard J Jabbour, Akihito Tanaka, Luca Testa, Vittorio Romano, Matteo Longoni, Manuela Giglio, Francesca Besana, Michele Cacucci, Eustachio Agricola, Alaide Chieffo, Ottavio Alfieri, Matteo Montorfano, Antonio Colombo, Azeem Latib
A high prevalence of mitral annular calcium (MAC) is expected in patients undergoing transcatheter aortic valve implantation (TAVI); however, data regarding the prevalence of MAC and impact on risk of cardiovascular events are lacking. To determine the prevalence of MAC and its association with clinical outcomes in patients undergoing TAVI, we retrospectively analyzed 424 patients who underwent transfemoral TAVI from 2007 to 2015 and whose preoperative computed tomography images were available for assessment of MAC...
December 15, 2017: American Journal of Cardiology
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
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