{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:34:46Z","timestamp":1791876886704,"version":"4.3.4"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Mitral annular calcification (MAC) is a chronic process involving mitral valve annulus, linked with an increased cardiovascular mortality and morbidity. Since its first autoptic description, a progressive evolution in diagnostic tools brought cardiac computed tomography (CT) scan to become the gold standard in MAC detection and classification. The treatment of significant mitral valve disease in patients with annular calcifications has always represented an issue for cardiac surgeons, being it linked with an increased risk of atrioventricular groove rupture, circumflex artery injury, or embolism. As a consequence, different surgical techniques have been developed over time in order to reduce the incidence of these fearsome complications. Recently, transcatheter mitral valve replacement (TMVR) has emerged as a valid alternative to surgery in high-risk patients. Both hybrid transatrial, transfemoral, or transapical approaches have been described to deliver balloon-expandable or self-expanding aortic transcatheter valves into the calcified annulus, with conflicting early and long-term results. Tendyne (Abbott Structural Heart, Santa Clara, CA, USA) is a promising transapical-delivered option. Early results have shown effectiveness and safety of this device in patients with MAC and severe mitral valve disease, with the lowest rate of embolization, mortality, and left ventricular outflow tract obstruction (LVOTO) reported so far.<\/jats:p>","DOI":"10.3389\/fcvm.2022.1033565","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:31:16Z","timestamp":1669005076000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Mitral annular calcification in patients with significant mitral valve disease: An old problem with new solutions"],"prefix":"10.3389","volume":"9","author":[{"given":"Guido","family":"Ascione","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1016\/j.jacc.2015.08.872","article-title":"Mitral annulus calcification.","volume":"66","author":"Abramowitz","year":"2015","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1161\/01.cir.0000058168.26163.bc","article-title":"Mitral annular calcification predicts cardiovascular morbidity and mortality: the Framingham heart study.","volume":"107","author":"Fox","year":"2003","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.amjcard.2022.03.041","article-title":"Clinical outcomes of mitral valve disease with mitral annular calcification.","volume":"174","author":"Fukui","year":"2022","journal-title":"Am J Cardiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1056\/NEJM196211012671802","article-title":"Massive calcification of the mitral annulus. 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A 10 years experience.","volume":"110","author":"David","year":"1995","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"202","DOI":"10.4414\/cvm.2012.01677","article-title":"Worldwide first surgical implantation of a transcatheter valved stent in mitral position.","volume":"15","author":"Carrel","year":"2012","journal-title":"Cardiovasc Med."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018514","article-title":"Surgical and transcatheter mitral valve replacement in mitral annular calcification: a systematic review.","volume":"10","author":"Alexis","year":"2021","journal-title":"J Am Heart Assoc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.jtcvs.2018.03.016","article-title":"Transatrial implantation of a transcatheter heart valve for severe mitral annular calcification.","volume":"156","author":"Praz","year":"2018","journal-title":"J Thorac Cardiovasc Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.iccl.2019.02.003","article-title":"Transcatheter mitral valve replacement with Tendyne.","volume":"8","author":"Niikura","year":"2019","journal-title":"Interv Cardiol Clin."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.4244\/EIJ-D-21-00745","article-title":"Early outcomes of transcatheter mitral valve replacement with the Tendyne system in severe mitral annular calcification.","volume":"17","author":"G\u00f6ssl","year":"2022","journal-title":"EuroIntervention."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/j.athoracsur.2019.04.080","article-title":"Characterizing risks associated with mitral annular calcification in mitral valve replacement.","volume":"108","author":"Kaneko","year":"2019","journal-title":"Ann Thorac Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.jcin.2017.01.035","article-title":"Intentional percutaneous laceration of the anterior mitral leaflet to prevent outflow obstruction during transcatheter mitral valve replacement: first-in-human experience.","volume":"10","author":"Babaliaros","year":"2017","journal-title":"JACC Cardiovasc Interv."},{"key":"B19","doi-asserted-by":"publisher","first-page":"2521","DOI":"10.1016\/j.jacc.2019.02.076","article-title":"Anterior leaflet laceration to prevent ventricular outflow tract obstruction during transcatheter mitral valve replacement.","volume":"73","author":"Khan","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2030","DOI":"10.1016\/j.athoracsur.2017.05.008","article-title":"Transapical mitral valve implantation for native mitral valve stenosis using a balloon-expandable prosthesis.","volume":"104","author":"Kiefer","year":"2017","journal-title":"Ann Thorac Surg."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.1033565\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T04:31:19Z","timestamp":1669005079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.1033565\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,21]]},"references-count":20,"alternative-id":["10.3389\/fcvm.2022.1033565"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.1033565","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,21]]},"article-number":"1033565"}}