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Management of Patients With Severe Mitral Annular Calcification: JACC State-of-the-Art Review

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Omar Chehab, Ross Roberts-Thomson, Antonio Bivona, Harminder Gill, Tiffany Patterson, Amit Pursnani, Karine Grigoryan, Bernardo Vargas, Ujala Bokhary, Christopher Blauth, Gianluca Lucchese, Vinayak Bapat, Mayra Guerrero, Simon Redwood, Bernard Prendergast, Ronak Rajani

Original languageEnglish
Pages (from-to)722-738
Number of pages17
JournalJournal of the American College of Cardiology
Volume80
Issue number7
DOIs
Published16 Aug 2022

Bibliographical note

Funding Information: Dr Lucchese has been a consultant for and received speaker fees from Edwards Lifesciences, Cryolife, and Bard- DB . Dr Bapat has received speaker/consultancy fees and research grant support from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott. Dr Guerrero has received research grant support from Abbott Structural Heart and Edwards Lifesciences . Dr Redwood has received speaker fees from Edwards Lifesciences . Dr Prendergast has received unrestricted research and educational grants from Edwards Lifesciences; and has received speaker/consultancy fees from Abbott, Medtronic, Microport, Anteris, and Edwards Lifesciences. Dr Rajani has received speaker/consultancy fees from Siemens Healthineers, GE Healthcare, Medtronic, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Funding Information: Dr Lucchese has been a consultant for and received speaker fees from Edwards Lifesciences, Cryolife, and Bard-DB. Dr Bapat has received speaker/consultancy fees and research grant support from Edwards Lifesciences, Medtronic, Boston Scientific, and Abbott. Dr Guerrero has received research grant support from Abbott Structural Heart and Edwards Lifesciences. Dr Redwood has received speaker fees from Edwards Lifesciences. Dr Prendergast has received unrestricted research and educational grants from Edwards Lifesciences; and has received speaker/consultancy fees from Abbott, Medtronic, Microport, Anteris, and Edwards Lifesciences. Dr Rajani has received speaker/consultancy fees from Siemens Healthineers, GE Healthcare, Medtronic, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.The authors thank FEops HEARTguide (Ghent, Belgium) for the finite element planning images (Figure 5) and GE Healthcare (Illinois, USA) for their support with the simulation fusion cases at Guy's and St Thomas’ NHS Foundation Trust. They also thank Prof Steven Niederer, Dr Adelaide De Vecchi, and Samuel Hill from the School of Bioengineering and Imaging Sciences at King's College, London, for their computational fluid dynamic modeling program of left ventricular outflow physiology. Publisher Copyright: © 2022 American College of Cardiology Foundation

King's Authors

Abstract

Mitral annular calcification (MAC) is a common and challenging pathologic condition, especially in the context of an aging society. Surgical mitral valve intervention in patients with MAC is difficult, with varying approaches to the calcified annular anatomy, and the advent of transcatheter valve interventions has provided additional treatment options. Advanced imaging provides the foundation for heart team discussions and management decisions concerning individual patients. This review focuses on the prognosis of, preoperative planning for, and management strategies for patients with MAC.

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