ArticleAnnals of cardiothoracic surgery2025
Impact of mitral annular calcification in mitral valve surgery: 25-year Mayo Clinic experience.
Article in Annals of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Annular calcification [mitral annular calcification (MAC)] may complicate mitral valve (MV) surgery, and long‑term outcome data are limited. Methods: We reviewed adult patients undergoing MV surgery at our Clinic between January 2000 and December 2024. MAC was identified on preoperative imaging, and operative strategy prioritized repair when feasible and employed conservative debridement when necessary. Patients with MAC were matched 1:1 with patients without MAC using a propensity score. Results: Among 11,350 MV operations with or without concomitant procedures, 1,603 patients (14.1%) had MAC, the median age was 72.6 years [interquartile range (IQR), 65.3-78.6 years], 54.8% were female. In the MAC cohort, 21% of patients had a prior sternotomy. Concomitant aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) were performed in 32% and 24% of cases, respectively. Compared with propensity-matched controls, MAC patients did not exhibit significantly prolonged cardiopulmonary bypass times (115 Conclusions: In this large single-center series, patients with MAC often had associated aortic valve and coronary artery disease, and 21% of them were undergoing a second procedure. Compared to matched patients without MAC, long-term survival was reduced in patients with MAC. This experience highlights the importance of accurate preoperative assessment and tailored surgical strategy to achieve acceptable outcomes of MV surgery in the presence of MAC.
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