JUAN A. CRESTANELLO: Welcome to the Cardiovascular Surgery Series, where I review the latest research in cardiovascular surgery from the Mayo Clinic. I am Dr. Juan Crestanello. I am a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota.

I will discuss today the prevalence and natural history of mitral annular calcification and related valve dysfunctions. MAC was present in 23% of almost 25,000 patients who had echocardiograms at the Mayo Clinic in 2015. The prevalence of mitral valve disease was higher in patients with MAC compared to patients without mitral annular calcifications.

Patients with MAC were older, more often female, and had substantial comorbidities including risk factors for atherosclerosis such as hypertension, diabetes, renal failure, and previous mediastinal radiation. They also had an increase incidence of cerebrovascular, peripheral vascular, and coronary artery disease. Patients with MAC had hypertrophic left ventricles, with left ventricular outflow tract obstruction, and also had mitral stenosis and aortic stenosis.

MAC determines a bad prognosis. Patients with MAC had a worse survival than those without MAC. And the survival of patients with MAC and mitral valve disease was the worst. This study provides important insight into the patients with mitral annular calcification.

Number one, patients with MAC are higher risk because they have many comorbidities. Number two, MAC is associated with bad outcomes. And mitral valve disease is more common in patients with MAC. And among those patients with MAC, those with mitral valve disease have the worst outcomes. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.