Evidence mapPaperPMID 33728929Full record

SynthesisJournal of the American Heart Association2021

Surgical and Transcatheter Mitral Valve Replacement in Mitral Annular Calcification: A Systematic Review.

Sophia L Alexis, Aaqib H Malik, Ahmed El-Eshmawi, Isaac George, Aditya Sengupta, Susheel K Kodali, Rebecca T Hahn, Omar K Khalique, Syed Zaid, Mayra Guerrero and 4 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
6.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
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  8. Review
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  13. Mitral Annular Calcification: Natural History, Prognosis, and Clinical Outcomes.Journal of the Society for Cardiovascular Angiography & Interventions · 2025
    Article
  14. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

Sophia L AlexisDepartment of Cardiovascular Surgery Mount Sinai Health System New York NY.
Aaqib H MalikDepartment of Medicine Westchester Medical Center Valhalla NY.
Ahmed El-EshmawiDepartment of Cardiovascular Surgery Mount Sinai Health System New York NY.
Isaac GeorgeDivision of Cardiac Surgery New York Presbyterian Hospital/Columbia University Medical Center New York NY.
Aditya SenguptaDepartment of Cardiovascular Surgery Mount Sinai Health System New York NY.
Susheel K KodaliDivision of Cardiology New York Presbyterian Hospital/Columbia University Medical Center New York NY.
Rebecca T HahnDivision of Cardiology New York Presbyterian Hospital/Columbia University Medical Center New York NY.
Omar K KhaliqueDivision of Cardiology New York Presbyterian Hospital/Columbia University Medical Center New York NY.
Syed ZaidDepartment of Cardiology Westchester Medical Center Valhalla NY.
Mayra GuerreroDivision of Cardiology Mayo Clinic Rochester MN.
Vinayak N BapatDepartment of Cardiothoracic Surgery, Minneapolis Heart Institute Abbott Northwestern Hospital Minneapolis MN.
Martin B LeonDivision of Cardiology New York Presbyterian Hospital/Columbia University Medical Center New York NY.
David H AdamsDepartment of Cardiovascular Surgery Mount Sinai Health System New York NY.
Gilbert H L TangDepartment of Cardiovascular Surgery Mount Sinai Health System New York NY.
Mount Sinai Health System · USNewYork–Presbyterian Hospital · USWestchester Medical Center · USAbbott Northwestern Hospital · USMayo Clinic in Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Mitral annular calcification with mitral valve disease is a challenging problem that could necessitate surgical mitral valve replacement (SMVR). Transcatheter mitral valve replacement (TMVR) is emerging as a feasible alternative in high-risk patients with appropriate anatomy. PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception to December 25, 2019 for studies discussing SMVR or TMVR in patients with mitral annular calcification; 27 of 1539 articles were selected for final review. TMVR was used in 15 studies. Relevant data were available on 82 patients who underwent hybrid transatrial TMVR, and 354 patients who underwent transapical or transseptal TMVR. Outcomes on SMVR were generally reported as small case series (447 patients from 11 studies); however, 1 large study recently reported outcomes in 9551 patients. Patients who underwent TMVR had a shorter median follow-up of 9 to 12 months (range, in-hospital‒19 months) compared with patients with SMVR (54 months; range, in-hospital‒120 months). Overall, those undergoing TMVR were older and had higher Society of Thoracic Surgeons risk scores. SMVR showed a wide range of early (0%-27%; median 6.3%) and long-term mortality (0%-65%; median at 1 year, 15.8%; 5 years, 38.8%, 10 years, 62.4%). The median in-hospital, 30-day, and 1-year mortality rates were 16.7%, 22.7%, and 43%, respectively, for transseptal/transapical TMVR, and 9.5%, 20.0%, and 40%, respectively, for transatrial TMVR. Mitral annular calcification is a complex disease and TMVR, with a versatile option of transatrial approach in patients with challenging anatomy, offers a promising alternative to SMVR in high-risk patients. However, further studies are needed to improve technology, patient selection, operative expertise, and long-term outcomes.

Indexed as

CalcinosisCardiac CatheterizationHeart Valve DiseasesHeart Valve Prosthesis ImplantationAgedHumansMitral ValvePostoperative ComplicationsTreatment Outcomemitral annulus calcificationmitral valvemitral valve replacementtranscatheter

Identifiers

PMID33728929
PMCPMC8174336
OpenAlexW3137351175

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.