LAUSR

Severe mitral annular calcification (MAC) is occasionally associated with degenerative mitral valve dysfunction especially in the elderly and renal patients. Dealing with the MAC at the time of mitral valve replacement is difficult and hazardous. Currently two techniques exist. The first involves extensive decalcification of the annulus followed by pericardial patching of the resulting gusset. The second technique is where the prosthesis is sutured within the atrium creating a new annulus. Complications of the first include atrio-ventricular disruption, circumflex artery injury and ventricular rupture while the second technique is associated with paravalvular leak, valve dehiscence and thromboembolism.