Journal
JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
Volume 34, Issue 9, Pages 923-931Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.echo.2021.04.007
Keywords
Mitral annular calcification; Calcific mitral stenosis; Degenerative mitral stenosis; Caseous mitral annular calcification; Mitral valve dimensionless index
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As life expectancy increases, mitral annular calcification is becoming more prevalent and can lead to valve stenosis, traditional methods for measuring mitral valve area may not be suitable for calcific MS, flow-independent methods should be used to assess the severity of the lesions.
As the life expectancy of the population continues to increase, mitral annular calcification has emerged as an important cause of mitral stenosis (MS), commonly referred to as calcific or degenerative MS. Mitral annular calcification results in valvular stenosis when calcification extends into the base of the mitral leaflet(s) and displaces the mitral valve hinge point(s) into the left ventricular inlet. Echocardiographic determination of mitral vale area is fraught with difficulties and often precludes using planimetry or the Hatle formula. Given the numerous confounders that affect transmitral flow in calcific MS, evaluation of lesion severity should incorporate flow-independent methods such as the continuity equation and the mitral valve dimensionless index. In light of the significant risks entailed, there is little enthusiasm for mitral valve replacement in patients with calcific MS. Transcatheter mitral valve replacement is generally offered on a compassionate use basis to patients deemed to be at high surgical risk. (J Am Soc Echocardiogr 2021;34:923-31.)
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