Mitral Valve Replacement for Mitral Stenosis Secondary to Massive Mitral Annular Calcium
Section snippets
Patients Studied
Since March 1993, one of us (WCR) has examined, described, and submitted the report on all surgical specimens excised by cardiac surgeons at Baylor University Medical Center (BUMC). From January 2016 to April 2022, portions of the mitral valve in 215 patients were submitted to the surgical pathology unit of the department of Pathology at BUMC (Figure 1). Of the 215 patients, 52 (24%) had mitral valve repair for pure mitral regurgitation, and 163 (76%) had mitral valve replacement. Of the latter
Results
Pertinent clinical and morphologic findings in the 11 patients are summarized in table 1. The ages at the time of the mitral valve replacement ranged from 37 to 83 years (median 70); 6 were women and 5 were men. Preoperatively, the mean gradient between left atrium and left ventricle ranged from 9 to 15 mmHg (average 12). Four patients had renal replacement therapy due to chronic kidney disease and 3 patients had coronary revascularization. Three patients had atrial fibrillation. Four patients
Comment
The purpose of this article is to again emphasize the potential dangers of replacing a mitral valve made stenotic by massive MAC. In a previous study1 on this topic the mortality following this procedure was high, and as the Tirone E. David group has emphasized the results of replacing and/or repairing the mitral valve in the setting of “extensive” MAC is 6.2 times higher than that occurring in patients having mitral valve procedures at their institution without MAC.2,3 Even in their patients
Declaration of interests
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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