JUAN CRESTANELLO: Welcome to the cardiovascular surgery series, where we review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes. I am Juan Crestanello, and I am a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota. We will discuss today the article entitled "Does mitral valve calcium in patients undergoing mitral valve replacement portend worse survival?"
Mitral valve surgery in patients with mitral annular calcification is one of the most significant surgical challenges faced by cardiac surgeons. We reviewed 496 patients who had isolated mitral valve replacement. MAC was present in 23% of those patients. Patients with MAC had significant comorbidities, such as older age, peripheral vascular disease, diabetes, dialysis, and previous aortic valve surgery.
We use a conservative approach, with limited leaflet and annular debridement to allow the placement of a mitral prostheses. We use mechanical valve in 50% of the patients. Operating mortality was low, 1%, in patients with MAC, and the rate of moderate prevalvular leak was only 4%. There was not an increase in the risk of preoperative stroke.
Patients with MAC had a significant worse long-term survival, but after adjusting for comorbidities, MAC was not a risk factor for long-term mortality. We conclude that a conservative approach to treat mitral annular calcification achieves satisfactory results. Patients with MAC have significant comorbidities, contributing to a worse long-term survival, though MAC in itself is not a risk factor for mortality. Thank you for listening to the Mayo Clinic cardiovascular surgery series.