Mitral calcification in aortic stenosis

To appreciate the incidence, the promoting factors and the consequences of mitral calcification in aortic stenosis (AS), the data from 675 patients operated on for AS were reviewed. Mitral calcification was revealed by fluoroscopy, echocardiography and/or surgery. Mitral annular calcification (MAC) was observed in 169 patients (25%). In patients with MAC, females were more frequent (42.3 vs. 17.9%, P less than 0.0001), age was greater (64 vs. 58 years, P less than 10(-7)), AS was more severe (0.6 vs. 0.7 cm2, P less than 0.002), and LV walls were thicker (interventricular septum 13.5 vs. 12 mm, P less than 0.0003 posterior wall 12.8 vs. 11.9 mm, P less than 0.004). First-degree AV block was more frequent in patients with MAC but did not lead to more frequent pacemaker implantation. Mitral anterior leaflet calcification was noted in 215 patients (31.8%). When massive, it created mitral stenosis which, in one case, required later mitral replacement. Five- and ten-year actuarial survival rates were not different in patients with or without mitral calcification. We conclude that mitral calcification is frequent in AS. Promoting factors for MAC are age, severity of AS, and female gender.