Key result
TMVR in extreme-risk patients with severe MAC is feasible but linked to ~54% 1-year mortality.
Why the study?
Surgical mitral valve replacement carries high risk in severe mitral annular calcification, prompting the need to evaluate 1-year outcomes of transcatheter mitral valve replacement using balloon-expandable aortic valves.
Cohort (n=106)
Yes
TMVR with balloon-expandable aortic valves in extreme surgical risk patients with severe MAC is feasible but associated with high 1-year mortality (53.7%), though survivors show sustained symptomatic improvement.
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The outcomes have been really not much better than what we have with surgery.”
“these results open the door to a novel therapeutic option for patients with MAC. We can now anticipate that the transcatheter field may offer a more reliable alternative to open surgery for patients with severe MAC.”
High mortality after TMVR in severe MAC warrants cautious patient selection; hypothesis-generating for refined devices and techniques in this population.
Guerrero et al. (2018) conducted a cohort in Severe mitral annular calcification (n=106). Transcatheter mitral valve replacement (TMVR) was evaluated on 1-year all-cause mortality. Transcatheter mitral valve replacement in extreme surgical risk patients with severe mitral annular calcification is feasible but associated with 25% 30-day and 53.7% 1-year all-cause mortality.
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