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

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

doi:10.1016/j.jacc.2022.06.009

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

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

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

19 Citations (Scopus)

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.

Original language	English
Pages (from-to)	722-738
Number of pages	17
Journal	Journal of the American College of Cardiology
Volume	80
Issue number	7
DOIs	https://doi.org/10.1016/j.jacc.2022.06.009
Publication status	Published - 16 Aug 2022

Keywords

mitral annular calcification
mitral valve
surgery
valve-in-MAC

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10.1016/j.jacc.2022.06.009

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Chehab, O., Roberts-Thomson, R., Bivona, A., Gill, H., Patterson, T., Pursnani, A., Grigoryan, K., Vargas, B., Bokhary, U., Blauth, C., Lucchese, G., Bapat, V., Guerrero, M., Redwood, S., Prendergast, B., & Rajani, R. (2022). Management of Patients With Severe Mitral Annular Calcification: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 80(7), 722-738. https://doi.org/10.1016/j.jacc.2022.06.009

@article{eece29bac9ad4cbeb722e96fe6a83916,

title = "Management of Patients With Severe Mitral Annular Calcification: JACC State-of-the-Art Review",

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.",

keywords = "mitral annular calcification, mitral valve, surgery, valve-in-MAC",

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

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{\textquoteright} 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: {\textcopyright} 2022 American College of Cardiology Foundation",

year = "2022",

month = aug,

day = "16",

doi = "10.1016/j.jacc.2022.06.009",

language = "English",

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Chehab, O, Roberts-Thomson, R, Bivona, A, Gill, H , Patterson, T, Pursnani, A, Grigoryan, K, Vargas, B, Bokhary, U, Blauth, C, Lucchese, G, Bapat, V, Guerrero, M, Redwood, S , Prendergast, B & Rajani, R 2022, 'Management of Patients With Severe Mitral Annular Calcification: JACC State-of-the-Art Review', Journal of the American College of Cardiology, vol. 80, no. 7, pp. 722-738. https://doi.org/10.1016/j.jacc.2022.06.009

TY - JOUR

T1 - Management of Patients With Severe Mitral Annular Calcification

T2 - JACC State-of-the-Art Review

AU - Chehab, Omar

AU - Roberts-Thomson, Ross

AU - Bivona, Antonio

AU - Gill, Harminder

AU - Patterson, Tiffany

AU - Pursnani, Amit

AU - Grigoryan, Karine

AU - Vargas, Bernardo

AU - Bokhary, Ujala

AU - Blauth, Christopher

AU - Lucchese, Gianluca

AU - Bapat, Vinayak

AU - Guerrero, Mayra

AU - Redwood, Simon

AU - Prendergast, Bernard

AU - Rajani, Ronak

N1 - 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

PY - 2022/8/16

Y1 - 2022/8/16

N2 - 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.

AB - 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.

KW - mitral annular calcification

KW - mitral valve

KW - surgery

KW - valve-in-MAC

UR - http://www.scopus.com/inward/record.url?scp=85136343083&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2022.06.009

DO - 10.1016/j.jacc.2022.06.009

M3 - Review article

C2 - 35953138

AN - SCOPUS:85136343083

SN - 0735-1097

VL - 80

SP - 722

EP - 738

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 7

ER -

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

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Keywords

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