INVASIVE INTERVENTIONS IN STRUCTURAL HEART DISEASES: COMPREHENSIVE TECHNIQUES

Invasive Interventions in Structural Heart Diseases-kapak

DISEASE-BASED MANAGEMENT OF MITRAL ANNULAR CALCIFICATION

Yücel Kanal

Cumhuriyet University, Faculty of Medicine, Department of Cardiology, Sivas, Türkiye

Kanal Y. Disease-Based Management of Mitral Annular Calcification. In: Tanık VO, Özlek B, editors. Invasive Interventions in Structural Heart Diseases: Comprehensive Techniques. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.151-163.

ABSTRACT

The incidence of degenerative mitral valve disease (DMKD) has increased with increasing life expectancy, particularly in highand middle-income countries. Patients with DMKD may present with mitral regurgitation (MR), mitral stenosis (MR), or both. Although surgical intervention is the gold standard in the treatment of symptomatic DMKH patients, surgery is not feasible in half of them, especially because of the elderly age and comorbidities. Another cause of difficulty in the management of patients with DMCH is mitral valve annular calcification (MAK). MAK is associated with increased mortality and morbidity in patients undergoing mitral valve surgery. Severe MAK is observed in 8-15% of patients with mitral valve disease. Due to the increased surgical risk in patients with MAK, transcatheter treatments have been considered in recent years and transcatheter mitral valve replacement (TMVR) has emerged as an alternative treatment in patients with suitable anatomy. Successful results have been obtained in TMVR with balloon-expandable valves via transapical, transseptal, and transfemoral routes. In addition, dedicated devices have recently been developed for transcatheter use in patients with MAK and various studies are ongoing in this field. In this book chapter, we aimed to discuss TMVR in detail.

Keywords: Mitral valve; Mitral valve stenosis; Mitral regurgitation; Mitral annular calcification; TMVR

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