TY - JOUR AU - Misfeld, Martin AU - Yan, Tristan D. PY - 2025 TI - Mitral valve surgery in mitral annular calcification JF - Annals of Cardiothoracic Surgery; Vol 14, No 6 (November 30, 2025): Mitral Annular Calcification Y2 - 2025 KW - N2 - Mitral annular calcification (MAC) remains a challenging pathology in the context of mitral valve disease. It is associated with known cardiovascular risk factors, as well as a variety of chronic inflammatory, infective, or connective tissue diseases. Surgically, patients are at specific operative risk for atrioventricular dehiscence or rupture and/or injury to the circumflex artery. To mitigate these risks, a broad portfolio of surgical options exists to safely anchor annular sutures. This can be performed after the calcium bar has been removed and the posterior annulus reconstructed with a patch, or even when the calcium bar is left in place. Knowledge of these techniques will help surgeons manage MAC and implant a properly sized valve. Even in the presence of severe MAC with additional involvement of the mitral valve leaflets, transatrial transcatheter heart valve (THV) implantation may be a viable option. An individualized decision-making process to determine the applicable technique should be used for patients with MAC, leading to adequate treatment for this high-risk patient group. UR - https://www.annalscts.com/article/view/17285