Evidence mapPaperPMID 41801638Full record

ArticleCardiovascular drugs and therapy2026

Minimally Invasive Trans-atrial Mitral Valve Replacement Using a Balloon-expandable Transcatheter Valve in the Setting of Severe Mitral Annular Calcification.

Syed B Peer, Prakash Jayanthi, Zachary Gray, Aladdein Mattar, Guilherme Silva, Srikanth Koneru, Kenneth Liao

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Article in Cardiovascular drugs and therapy, 2026. 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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5 · Who and what money

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7 authors.

Syed B PeerDepartment of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA.ORCID http://orcid.org/0009-0002-2334-0449
Prakash JayanthiDepartment of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA.
Zachary GrayDepartment of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA.
Aladdein MattarDepartment of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA.
Guilherme SilvaDepartment of Cardiology, Baylor College of Medicine, Houston, TX, USA.
Srikanth KoneruDepartment of Cardiology, Baylor College of Medicine, Houston, TX, USA.
Kenneth LiaoDepartment of Surgery, Division of Cardiothoracic Surgery, Baylor College of Medicine/Texas Heart Institute, Houston, TX, USA. Kenneth.liao@bcm.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSevere mitral annular calcification (MAC) increases the complexity and risk of conventional mitral valve replacement (MVR) for patients with mitral stenosis (MS) and/or regurgitation (MR). In patients with severe concentric MAC who were not candidates for a traditional surgical approach, trans-atrial transcatheter MVR (TMVR) using a balloon-expandable transcatheter aortic valve (TAVR) is an alternative. We report our experience using this technique through a minimally invasive approach.

methodsFrom April 2017 to September 2024, twenty-five symptomatic patients with severe MS and/or MR and MAC underwent minimally invasive trans-atrial TMVR with a TAVR valve at our institution. All patients had severe concentric MAC and were deemed ineligible for conventional MVR.

resultsMean age of the patients was 74.6 ± 10.9 years and 84% (21/25) were female. Mean STS (Society of Thoracic Surgery) risk score for mortality was 9.1% ± 4.8%. Operative indication was severe MS in 11 patients (44%), severe MR in 4 (16%) and mixed MS/MR in 10 (40%). Surgical approach was via right anterior mini-thoracotomy (n=21) or robotic (n=4). Five patients had prior open cardiac surgery, and 6 had prior TAVR. Six patients (24%) were under cold fibrillatory arrest. Complications included paravalvular leak requiring re-intervention (n=1), left ventricular outflow tract obstruction (n=1) and atrio-ventricular groove disruption (n=1). There were no perioperative strokes. Average hospital length-of-stay was 7 days (IQR 6–13). Operative mortality was 16% (4/25), 76.0% (19/25) of patients survived discharge, and 1-year survival was 64.0% (16/25).

conclusionMinimally invasive trans-atrial TMVR using a TAVR valve provides a viable alternative therapy for patients with severe MAC who are not candidates for conventional MVR.

Indexed as

Mitral annular calcificationMitral valve replacementTranscatheter valve

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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.