Repair of left ventricular rupture in a patient with mitral annular calcification

Tazume, Hirokazu; Koga, Ayumi; Fukui, Toshihiro

doi:10.1093/icvts/ivx040

Cited by 1 publication

(1 citation statement)

References 5 publications

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“…Further, MAC sometimes serves as a nidus for infective endocarditis (IE) 5,6 or causes left ventricular (LV) rupture. 7 In such cases, complete resection of the calcified annulus is indispensable to achieve satisfactory outcomes. It is desirable for surgeons to have a skill set to accomplish extensive decalcification and reconstruction of the mitral annulus in a safe and reproducible manner.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of mitral valve replacement with complete annular decalcification

Numaguchi,

Takaki,

Nishigawa

et al. 2023

Asian Cardiovasc Thorac Ann

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Background This study aimed to examine the clinical outcomes of mitral valve replacement (MVR) in patients with severe mitral annular calcification (MAC) who required extensive decalcification and mitral annular reconstruction. Methods We reviewed 15 patients with severe MAC who underwent MVR between January 2016 and May 2022. In all cases, the calcified mitral annulus was resected completely using a Cavitron Ultrasound Surgical Aspirator, and a new annulus was created using bovine pericardium. In the acute postoperative phase, strict afterload reduction therapy using an intra-aortic balloon pump (IABP) was administered. Results The mean age of patients was 73 ± 8 years, and 13 (86.7%) were women. Concomitant aortic valve replacement was performed in 11 (73.3%) patients, tricuspid annuloplasty in 9 (60.0%), coronary artery bypass grafting in 1 (6.7%), and arrhythmia surgery in 7 (46.7%). The mean aortic cross-clamp and cardiopulmonary bypass times were 143 ± 32 min and 175 ± 34 min, respectively. In 13 patients, an IABP was used for 2 or 3 days postoperatively. There were no in-hospital deaths, left ventricular ruptures, or other MAC-related complications. Postoperative echocardiography revealed no paravalvular leakages. Conclusion Our strategy for managing severe MAC is safe and reproducible even in relatively high-risk patients. Afterload reduction using an IABP in the acute postoperative phase may reduce the risk of fatal complications after extensive decalcification and mitral annular reconstruction.

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Section: Introductionmentioning

confidence: 99%