Mitral annular calcification in patients undergoing aortic valve replacement for aortic valve stenosis

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• 作者：Yoshiyuki Takami ; Kazuyoshi Tajima
• 关键词：Aortic valve stenosis ; Aortic valve replacement ; Mitral annular calcification
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：31
• 期：2
• 页码：183-188
• 全文大小：548 KB
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• 作者单位：Yoshiyuki Takami (1)
  Kazuyoshi Tajima (2)
  
  1. Department of Cardiovascular Surgery, Kansai Medical University, Takii Hospital, 10-15 Fumizono-cho, Moriguchi, 570-8507, Japan
  2. Department of Cardiovascular Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Limited data exis t on clinical relevance of aortic valve stenosis (AVS) and mitral annular calcification (MAC), although with similar pathophysiologic basis. We sought to reveal the prevalence of MAC and its clinical features in the patients undergoing aortic valve replacement (AVR) for AVS. We reviewed 106 consecutive patients who underwent isolated AVR from 2004 to 2010. Before AVR, CT scans were performed to identify MAC, whose severity was graded on a scale of 0–4, with grade 0 denoting no MAC and grade 4 indicating severe MAC. Echocardiography was performed before AVR and at follow-up over 2 years after AVR. MAC was identified in 56 patients with grade 1 (30 %), 2 (39 %), 3 (18 %), and 4 (13 %), respectively. Patients with MAC presented older age (72 ± 8 versus 66 ± 11 years), higher rate of dialysis-dependent renal failure (43 versus 4 %), and less frequency of bicuspid aortic valve (9 versus 36 %), when compared to those without MAC. No significant differences were seen in short- and mid-term mortality after AVR between the groups. In patients with MAC, progression of neither mitral regurgitation nor stenosis was observed at follow-up of 53 ± 23 months for 102 survivors, although the transmitral flow velocities were higher than in those without MAC. In conclusion, MAC represented 53 % of the patients undergoing isolated AVR for AVS, usually appeared in dialysis-dependent elder patients with tricuspid AVS. MAC does not affect adversely upon the survival, without progression of mitral valve disease, at least within 2 years after AVR. Keywords Aortic valve stenosis Aortic valve replacement Mitral annular calcification