title: Mitral Annular Calcium and Mitral Stenosis Determined by Multidetector Computed Tomography in Patients Referred for Aortic Stenosis.
abstract: Mitral annular calcium (MAC) is a common finding in older patients referred for transcatheter aortic valve implantation (TAVI). Multidetector computed tomography (MDCT) allows fine quantification of the calcific deposits. Our objective was to estimate the prevalence of MAC and associated mitral stenosis (MS) in patients referred for TAVI using MDCT. A cohort of 346 consecutive patients referred for TAVI evaluation was screened by MDCT for MAC: 174 had MAC (50%). Of these patients, 165 patients (95%) had mitral valve area (MVA) assessable by MDCT planimetry (age 83.8 ± 5.9 years). Median mitral calcium volume and MVA were 545 mm3(193 to 1,253 mm3) and 234 mm2(187 to 297 mm2), respectively. The MS was very severe, severe, and moderate in 2%, 22%, and 10% patients, respectively. By multivariate analysis, MVA was independently correlated to mitral calcium volume, aortic annular area, and some specific patterns of mitral leaflet calcium. Based on these findings, a formula was elaborated to predict the presence of a significant MS. In conclusion, MDCT allows detailed assessment of MAC in TAVI populations, demonstrating a high prevalence. Mitral analysis should become routine during MDCT screening before TAVI as it may alter therapeutic strategy.
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France; University Hospital of Rangueil, Cardiac Imaging Center, Toulouse, France.
authors: Simon
authors: S
authors: Mejean
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France. Electronic address: erik.bouvier@yahoo.fr.
authors: Erik
authors: E
authors: Bouvier
authors: University Hospital of Rangueil, Cardiac Imaging Center, Toulouse, France.
authors: Vincent
authors: V
authors: Bataille
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France.
authors: Patrick
authors: P
authors: Seknadji
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France.
authors: Dominique
authors: D
authors: Fourchy
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France.
authors: Jean-Yves
authors: JY
authors: Tabet
authors: University Hospital of Rangueil, Cardiac Imaging Center, Toulouse, France.
authors: Olivier
authors: O
authors: Lairez
authors: Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Department of Cardiology and Cardiac Surgery, Massy, France.
authors: Bertrand
authors: B
authors: Cormier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D061330:Multidetector Computed Tomography; D015995:Prevalence; D012189:Retrospective Studies; D065467:Transcatheter Aortic Valve Replacement