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This commentary discusses the challenges of mitral annular calcification in mitral valve surgery and the trade-offs between 'resect' and 'respect' strategies.
Mitral annular calcification (MAC) is a challenge in patients requiring mitral valve intervention. MAC is associated with poor outcomes after mitral valve surgery,1 and there is no optimal surgical management strategy. The calcified annulus can be approached by decalcification combined with annular reconstruction (“resect strategy”) or by avoiding annular decalcification (“respect strategy”). Decalcification can allow for superior seating of the prosthesis and has a lower risk of paravalvular regurgitation.
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Georges et al. (2021) conducted an editorial in Degenerative bioprosthetic mitral valve stenosis (n=1). Transseptal transcatheter mitral valve-in-valve (TMViV) replacement was evaluated.
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