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Mitral annular calcification

Richard Cheng, Emily Tat, Robert J Siegel, Reza Arsanjani, Asma Hussaini, Moody Makar, Yukiko Mizutani, Alfredo Trento, Saibal Kar
AIMS: Mitral annular calcification (MAC) negatively influences outcomes in surgical mitral valve (MV) repair for mitral regurgitation (MR). However, there are no data on whether MAC impacts on outcomes of MitraClip percutaneous MV edge-to-edge repair. This study sought to investigate whether the presence of MAC impacts on the procedural success and durability of percutaneous transcatheter repair of MR using the MitraClip. METHODS AND RESULTS: One hundred and seventy-three patients undergoing MitraClip repair for significant MR were studied...
October 20, 2016: EuroIntervention
Jagdish C Mohan, Madhu Shukla, Vishwas Mohan, Arvind Sethi
Mitral annular calcification (MAC) has been considered a predisposition and an association of thrombo-embolic disease. Superimposed thrombus on MAC is under-appreciated as a potential cause of systemic thrombo-embolism. This report describes an elderly gentleman, who had recurrent cerebral embolism and in one of the episodes, a large mobile thrombus was detected on the ventricular surface of calcified mitral annulus. The thrombus disappeared after initiation of anti-coagulation.
September 2016: Indian Heart Journal
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
I Eweda, M Abul-Saud, H Fouad, R N Hanna, W Nammas
No abstract text is available yet for this article.
August 2016: Acta Cardiologica
Simon Mejean, Erik Bouvier, Vincent Bataille, Patrick Seknadji, Dominique Fourchy, Jean-Yves Tabet, Olivier Lairez, Bertrand Cormier
Mitral annular calcium (MAC) is a common finding in older patients referred for transcatheter aortic valve implantation (TAVI). Multidetector computed tomography (MDCT) allows fine quantification of the calcific deposits. Our objective was to estimate the prevalence of MAC and associated mitral stenosis (MS) in patients referred for TAVI using MDCT. A cohort of 346 consecutive patients referred for TAVI evaluation was screened by MDCT for MAC: 174 had MAC (50%). Of these patients, 165 patients (95%) had mitral valve area (MVA) assessable by MDCT planimetry (age 83...
October 15, 2016: American Journal of Cardiology
Talal S Alnabelsi, Yaser Alhamshari, Ramzi H Mulki, Jose N Codolosa, Nikoloz Koshkelashvili, Igor Goykhman, Gregg S Pressman, Abel Romero-Corral
Epicardial adipose tissue (EAT) has been linked to coronary artery calcium deposits and atherosclerotic disease. Mitral annular (MAC) and aortic valve calcium (AVC) have also been associated with atherosclerosis. This study examined the possible relation between EAT thickness and valvular calcium deposits. We included 294 patients aged ≥65 years who had noncontrast computed tomography scans of the chest. Mean age was 76 ± 7 years; 47% were men. Using reconstructed images, EAT thickness was measured at various locations...
October 1, 2016: American Journal of Cardiology
Suma H Konety, Ryan J Koene, Faye L Norby, Tony Wilsdon, Alvaro Alonso, David Siscovick, Nona Sotoodehnia, John Gottdiener, Ervin R Fox, Lin Y Chen, Selcuk Adabag, Aaron R Folsom
BACKGROUND: This study assessed the echocardiographic predictors of sudden cardiac death (SCD) within 2 population-based cohorts. METHODS AND RESULTS: Echocardiograms were obtained on 2383 participants (1993-1995) from the ARIC study (Atherosclerosis Risk in Communities; 100% black) and 5366 participants (1987-1989 and 1994-1995) from the CHS (Cardiovascular Health Study). The main outcome was physician-adjudicated SCD. We used Cox proportional-hazards models with incident coronary heart disease and heart failure as time-dependent covariates to assess the association between echocardiographic variables and SCD, adjusting for Framingham risk score variables, coronary heart disease, and renal function...
August 2016: Circulation. Cardiovascular Imaging
Carlos Cortés, Ignacio J Amat-Santos, Luis Nombela-Franco, Antonio J Muñoz-Garcia, Enrique Gutiérrez-Ibanes, José M De La Torre Hernandez, Juan G Córdoba-Soriano, Pilar Jimenez-Quevedo, José M Hernández-García, Ana Gonzalez-Mansilla, Javier Ruano, Jesús Jimenez-Mazuecos, Javier Castrodeza, Javier Tobar, Fabian Islas, Ana Revilla, Rishi Puri, Ana Puerto, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: This study sought to analyze the clinical impact of the degree and improvement of mitral regurgitation in TAVR recipients, validate the main imaging determinants of this improvement, and assess the potential candidates for double valve repair with percutaneous techniques. BACKGROUND: Many patients with severe aortic stenosis present with concomitant mitral regurgitation (MR). Cardiac imaging plays a key role in identifying prognostic factors of MR persistence after transcatheter aortic valve replacement (TAVR) and for planning its treatment...
August 8, 2016: JACC. Cardiovascular Interventions
Kazuyuki Saito, Mayumi Doi, Motohiro Karikusa, Konomi Sakata, Hiroki Sasaguri, Shuta Toru
We report here a 70 year-old male on maintenance hemodialysis who presented non-paralytic pontine exotropia. Brain MRI showed new right pons infarct. Transthoracic and transesophageal echocardiography revealed a mobile calcification at posterior mitral leaflet with rapid growing compared to 14 days ago. Neurological symptoms disappeared at least 10 days by a treatment with aspirin. Calcification reduced by a follow-up transthoracic echocardiography after 90 days from the beginning of neurological symptoms. We diagonosed him with cerebral infarction during the course of mobile mitral annular calcification-related calcified amorphous tumor...
August 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
Anna E Bortnick, Traci M Bartz, Joachim H Ix, Michel Chonchol, Alexander Reiner, Mary Cushman, David Owens, Eddy Barasch, David S Siscovick, John S Gottdiener, Jorge R Kizer
OBJECTIVE: Calcification of the aortic valve and adjacent structures involves inflammatory, lipid and mineral metabolism pathways. We hypothesised that circulating biomarkers reflecting these pathways are associated with cardiac calcification in older adults. METHODS: We investigated the associations of various biomarkers with valvular and annular calcification in the Cardiovascular Health Study. Of the 5888 participants, up to 3585 were eligible after exclusions for missing biomarker, covariate or echocardiographic data...
July 13, 2016: Heart: Official Journal of the British Cardiac Society
Mayra Guerrero, Danny Dvir, Dominique Himbert, Marina Urena, Mackram Eleid, Dee Dee Wang, Adam Greenbaum, Vaikom S Mahadevan, David Holzhey, Daniel O'Hair, Nicolas Dumonteil, Josep Rodés-Cabau, Nicolo Piazza, Jose H Palma, Augustin DeLago, Enrico Ferrari, Adam Witkowski, Olaf Wendler, Ran Kornowski, Pedro Martinez-Clark, Daniel Ciaburri, Richard Shemin, Sami Alnasser, David McAllister, Martin Bena, Faraz Kerendi, Gregory Pavlides, Jose J Sobrinho, Guilherme F Attizzani, Isaac George, George Nickenig, Amir-Ali Fassa, Alain Cribier, Vinnie Bapat, Ted Feldman, Charanjit Rihal, Alec Vahanian, John Webb, William O'Neill
OBJECTIVES: This study sought to evaluate the outcomes of the early experience of transcatheter mitral valve replacement (TMVR) with balloon-expandable valves in patients with severe mitral annular calcification (MAC) and reports the first large series from a multicenter global registry. BACKGROUND: The risk of surgical mitral valve replacement in patients with severe MAC is high. There are isolated reports of successful TMVR with balloon-expandable valves in this patient population...
July 11, 2016: JACC. Cardiovascular Interventions
Mayra Guerrero, Dee Dee Wang, William O'Neill
Transcatheter implantation of balloon expandable valves in native mitral valves (MV) has been performed in patients with severe MV annular calcification who are not good candidates for standard surgical MV replacement. Significant left ventricular outflow tract (LVOT) obstruction with hemodynamic compromise has been described as one of the potential complications of transcatheter MV replacement. Surgical rescue carries significant risk in this high-risk patient population. We describe a percutaneous technique to acutely decrease transcatheter MV replacement-induced LVOT obstruction...
July 5, 2016: Catheterization and Cardiovascular Interventions
Thierry P Carrel, Alberto Weber
Resection of the calcium bar and creation of a more compressible annulus with pericardium are necessary in case of extensive calcification of the mitral valve annulus in patients with advanced myxomatous degenerative disease. Such annular bar calcification is technically challenging and represents a risk factor for death following mitral valve operations, because of atrio-ventricular rupture or encroachment of the coronary arteries. We describe a safe limited segmental annular debridement away from the coronary arteries that allows enough flexibility of the remaining calcified annulus to perform reduction annuloplasty in a young female patient with severe mitral regurgitation and a highly dilated and severely calcified mitral annulus...
October 2016: Interactive Cardiovascular and Thoracic Surgery
Mohammad Abdelghani, Ernest Spitzer, Osama I I Soliman, Dietrich Beitzke, Roberta Laggner, Rafael Cavalcante, Hiroki Tateishi, Carlos M Campos, Luc Verstraeten, Yohei Sotomi, Erhan Tenekecioglu, Yoshinobu Onuma, Jan G Tijssen, Robbert J de Winter, Francesco Maisano, Patrick W Serruys
AIMS: Transcatheter mitral valve replacement (TMVR) provides definitive valve replacement through a minimally invasive procedure. In the setting of TMVR, it remains unclear how relevant the differences between different mitral annular (MA) diameters are. We sought to define a simplified and reproducible method to describe the MA size. METHODS AND RESULTS: Using cardiac computed tomography angiography (CTA) studies of 47 patients, 3D MA perimeter (P3D) was annotated...
June 26, 2016: European Heart Journal Cardiovascular Imaging
Giovanni Cioffi, Ombretta Viapiana, Federica Ognibeni, Andrea Dalbeni, Giovanni Orsolini, Silvano Adami, Davide Gatti, Maurizio Fisicaro, Luigi Tarantini, Maurizio Rossini
OBJECTIVES: Ascending aorta has an increased stiffness (AoSI) in rheumatoid arthritis (RA) patients due to their chronic inflammatory status. We assessed prevalence and factors associated with increased AoSI and its prognostic role in a large cohort of RA patients. METHODS: We prospectively analysed 226 RA patients without overt cardiac disease compared with 226 non-RA patients matched for cardiovascular risk factors (non-RA controls). Abnormally high AoSI was diagnosed if AoSI > 6...
May 6, 2016: European Journal of Preventive Cardiology
Karan Sud, Shikhar Agarwal, Akhil Parashar, Mohammad Q Raza, Kunal Patel, David Min, Leonardo L Rodriguez, Amar Krishnaswamy, Stephanie L Mick, A Marc Gillinov, E Murat Tuzcu, Samir R Kapadia
Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy...
April 19, 2016: Circulation
Mayra Guerrero, Marina Urena, Amit Pursnani, Dee D Wang, Alec Vahanian, William O'Neill, Ted Feldman, Dominique Himbert
Patients with mitral annular calcification (MAC) have high surgical risk for mitral valve replacement due to associated comorbidities and technical challenges related to calcium burden, precluding surgery in many patients. Transcatheter mitral valve replacement (TMVR) with the compassionate use of balloon expandable aortic transcatheter heart valves has been used in this clinical scenario. The purpose of this review was to summarize the early experience including successes and failures reported. TMVR might evolve into an acceptable alternative for selected patients with severe MAC who are not candidates for conventional mitral valve surgery...
June 2016: Journal of Cardiovascular Surgery
Mackram F Eleid, Allison K Cabalka, Matthew R Williams, Brian K Whisenant, Oluseun O Alli, Neil Fam, Peter M Pollak, Firas Barrow, Joseph F Malouf, Rick A Nishimura, Lyle D Joyce, Joseph A Dearani, Charanjit S Rihal
OBJECTIVES: This study sought to examine the feasibility, safety, and intermediate-term outcomes in patients undergoing percutaneous transvenous transcatheter mitral valve implantation in failed bioprosthesis, ring annuloplasty, and calcific mitral stenosis. BACKGROUND: Surgical mitral valve replacement in patients with previous surgery or severe mitral annular calcification (MAC) is often associated with high or prohibitive risk. METHODS: Percutaneous transfemoral antegrade transseptal implantation of Edwards SAPIEN prosthesis (Edwards Lifesciences, Irvine, California) was performed in 48 patients with degenerated mitral bioprosthesis (n = 33), previous ring annuloplasty (n = 9), and severe MAC (n = 6)...
June 13, 2016: JACC. Cardiovascular Interventions
Michael S Koeckert, Didier F Loulmet, Mathew R Williams, Peter J Neuburger, Eugene A Grossi
We describe the use of the Sapien XT, placed in the mitral position using a totally endoscopic robotic approach in a 76-year-old man with extensive circumferential mitral calcifications and severe stenosis. The patient was at high risk for traditional open surgery and a large mitral valve annulus prevented safe transcatheter deployment due to size mismatch. Our novel approach offered a minimally invasive technique for native mitral valve replacement in a high-risk patient with anatomical constraints prohibitive to conventional approaches...
May 2016: Journal of Cardiac Surgery
Cinzia D'Angelo, Silvia Zagnoni, Letizia Riva, Gianni Casella, Maria Giovanna Pallotti, Giuseppe Di Pasquale
Massive myocardial calcification is a very rare finding usually associated with previous myocardial infarction, ventricular aneurysms, myocarditis, endomyocardial fibrosis, tuberculosis and systemic metabolic disease such as sarcoidosis and primary hyperoxaluria. Rarely, it can be associated with idiopathic mitral annular calcification or rheumatic heart disease. We report an unusual case of massive myocardial calcification without other predisposing factors and with documented disease progression.
February 2016: Giornale Italiano di Cardiologia
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