Minimally invasive treatment of mitral valve disease with severe mitral annular calcification: Meeting paper for Mitral Conclave 2022.

OBJECTIVE: Mitral valve disease in presence of severe mitral annular calcification (MAC) remains a challenge for surgeons to address. Conventional surgical techniques have potential for heightened morbidity and mortality. The advent of transcatheter heart valve technology and transcatheter mitral valve replacement (TMVR) holds promise to treat mitral valve disease with MAC with excellent clinical outcomes.

METHODS: We review current treatment strategies for MAC and studies in which TMVR techniques were used.

RESULTS: Several studies and a global registry describe outcomes of TMVR for mitral valve disease with MAC. We describe our specific technique on how to perform a minimally invasive transatrial approach for TMVR.

CONCLUSIONS: TMVR demonstrates strong promise as a safe and effective way to treat mitral valve disease with MAC. We advocate for a minimally invasive transatrial approach when performing TMVR for mitral valve disease with MAC.