Mitral annular calcification

Q: What is the clinical evidence from this study?

Study design: Review. Population: Mitral annular calcification. Intervention: Transcatheter mitral valve procedures and surgical interventions.

Q: What does this research mean for the field?

Mitral annular calcification causes progressive mitral valve dysfunction and presents significant anatomical and technical challenges that require multimodality imaging and multidisciplinary planning for surgical and transcatheter management. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Elizabeth A. Kobe; Susan Keen; Shinya Unai; Bo Xu; Milind Y. Desai

doi:10.1016/j.jcct.2026.10.013

November 1, 2026Journal of cardiovascular computed tomographyOpen Access

Mitral annular calcification

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Key result

Mitral annular calcification interventions require multimodality imaging and heart team planning given complex anatomy.

Why the study?

Due to anatomic complexity, transcatheter and surgical interventions for mitral annular calcification carry significant procedural challenges requiring multimodality imaging and multidisciplinary heart team planning.

Key Points

To synthesize current evidence on the epidemiology, pathophysiology, multimodality imaging assessment, and transcatheter and surgical management strategies for mitral annular calcification.
Narrative review of mitral annular calcification (MAC) disease mechanisms and resulting valvular dysfunction.
Evaluation of multimodality imaging approaches and heart team collaborative models for preprocedural planning.
Overview of established surgical options, transcatheter mitral valve interventions, and management of procedural complications.
Calcium accumulation along the mitral annulus causes progressive stiffening and structural distortion, manifesting as mitral stenosis, mitral regurgitation, or mixed valvular disease.
Severe anatomical distortion and calcification create substantial technical challenges during both conventional open surgical and transcatheter interventions.
Preprocedural multimodality imaging and multidisciplinary heart team planning are critical to evaluate patient anatomy and minimize procedural complications.

Structured PICO

P

Population

Patients with mitral annular calcification (MAC) and MAC-related valvular dysfunction (mitral stenosis, mitral regurgitation, or mixed valvular disease)

I

Intervention

Multimodality imaging, transcatheter mitral valve procedures, and surgical options

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Implication

This review outlines the epidemiology and pathophysiology of mitral annular calcification and highlights the role of multimodality imaging, heart team evaluation, and transcatheter or surgical interventions for managing MAC-related valvular dysfunction.

Abstract

Mitral annular calcification (MAC) is a chronic, progressive, and degenerative process characterized by calcium deposition along the mitral annulus. This leads to stiffening and distortion of normal mitral annular architecture and ultimately MAC-related valvular dysfunction, which can manifest as mitral stenosis, mitral regurgitation, or mixed valvular disease. Due to its anatomic complexity, transcatheter and surgical interventions for MAC carry significant procedural challenges. As such, multi-modality imaging and multi-disciplinary heart team discussions are critical in MAC evaluation and procedural planning. This review summarizes the epidemiology and pathophysiology of MAC, highlights the critical role of multimodality imaging in the evaluation and procedural planning of MAC, and reviews established transcatheter mitral valve procedures and surgical options for managing MAC, MAC-related valvular dysfunction, and potential complications.

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Cite This Study

Kobe et al. (2026) conducted a review in Mitral annular calcification. Transcatheter mitral valve procedures and surgical interventions was evaluated. Transcatheter and surgical interventions for mitral annular calcification require multimodality imaging and heart team planning due to complex anatomy.

synapsesocial.com/papers/6af3463ebdf2424ebd04f7fc https://doi.org/10.1016/j.jcct.2026.10.013

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Mitral annular calcification

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Mitral annular calcification

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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