PDF(Pubmed)
Abstract：
Mitral annular calcification (MAC) is a progressive degenerative calcification of the mitral valve (MV) that is associated with mitral stenosis, regurgitation or both. Patients with MAC are poor candidates for MV surgery because of technical challenges and high peri-operative mortality. Transcatheter MV replacement (TMVR) has emerged as an option for such high surgical risk patients. This has been described with the use of the SAPIEN transcatheter heart valve (valve-in-MAC) and dedicated TMVR devices. Careful anatomic assessment is important to avoid complications of TMVR, such as left ventricular outflow tract obstruction, valve migration, embolization and paravalvular mitral regurgitation. In this review, we discuss the pathology, importance of preprocedural multimodality imaging for optimal patient selection, clinical outcomes and complications associated with TMVR in patients with MAC.
摘要：
二尖瓣环钙化（MAC）是二尖瓣（MV）的进行性退行性钙化，与二尖瓣狭窄有关，返流或两者兼而有之。由于技术挑战和高的围手术期死亡率，MAC患者是MV手术的不良候选者。经导管MV置换（TMVR）已成为此类高手术风险患者的一种选择。已通过使用SAPIEN经导管心脏瓣膜（MAC瓣膜）和专用TMVR设备进行了描述。仔细的解剖评估对于避免TMVR的并发症很重要，如左心室流出道梗阻,瓣膜迁移,栓塞和二尖瓣关闭不全。在这次审查中,我们讨论病理学，术前多模态成像对最佳患者选择的重要性，MAC患者的临床结局和与TMVR相关的并发症。
