{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:43:54Z","timestamp":1771461834594,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mitral annular calcification (MAC) has been an exclusion for many of the earlier pivotal trials that were instrumental in gaining device approval and indications for mitral transcatheter edge\u2010to\u2010edge repair (M\u2010TEER).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the impact of MAC on the procedural durability and success of newer generation MitraClip\u00ae systems (G3 and G4 systems).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from Northwell TEER registry. Patients that underwent M\u2010TEER with third or fourth generation MitraClip device were included. Patients were divided into \u2212MAC (none\u2010mild) and +MAC (moderate\u2010severe) groups. Procedural success was defined as \u2264 grade 2\u2009+\u2009mitral regurgitation (MR) postprocedure, and durability was defined as \u2264 grade 2\u2009+\u2009MR retention at 1 month and 1 year. Univariate analysis compared outcomes between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 260 M\u2010TEER patients, 160 were \u2212MAC and 100 were +MAC. Procedural success was comparable; however, there were three patients who required conversion to cardiac surgery during the index hospitalization in the +MAC group versus none in the \u2212MAC group (though this was not statistically significant). At 1\u2010month follow\u2010up, there were no significant differences in MR severity. At 1\u2010year follow\u2010up, +MAC had higher moderate\u2010severe MR (22.1% vs. 7.5%; <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and higher mean transmitral gradients (5.3 vs. 4.0 mmHg; <jats:italic>p<\/jats:italic>\u2009=\u20090.001) with no differences in mortality, New York Heart Association functional class or ejection fraction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In selective patients with high burden of MAC, contemporary M\u2010TEER is safe, and procedural success is similar to patients with none\u2010mild MAC. However, a loss of procedural durability was seen in +MAC group at 1\u2010year follow\u2010up. Further studies with longer follow\u2010ups are required to assess newer mTEER devices and their potential clinical implications in patients with a high burden of MAC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30988","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T07:54:56Z","timestamp":1709538896000},"page":"618-625","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Contemporary experience of mitral transcatheter edge\u2010to\u2010edge repair technology in patients with mitral annular calcification"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6095-5034","authenticated-orcid":false,"given":"Ahmad","family":"Mustafa","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Northwell Health New Hyde Park New York New York 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Northwell Health New Hyde Park New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chapman","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Northwell Health New Hyde Park New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5069-5829","authenticated-orcid":false,"given":"Ethan","family":"Paliwoda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Northwell Health New Hyde Park New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arber","family":"Kodra","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, Northwell Health New Hyde Park New York New York 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