Scientific Sessions 2025  /  Mitral Focus: Advances in Mitral Valve Disease Mechanisms and Management  /  Prognostic Significance of Mitral Annular Calcification Assessed by Computed Tomography for Transcatheter Edge-to-Edge Repair Outcomes
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American Heart Association

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Final ID: Sa3113

Prognostic Significance of Mitral Annular Calcification Assessed by Computed Tomography for Transcatheter Edge-to-Edge Repair Outcomes

Abstract Body (Do not enter title and authors here): Background
Mitral annular calcification (MAC) presents significant challenges for the transcatheter edge-to-edge repair (TEER) procedure. However, there are limited data on how the detailed anatomical features of MAC assessed by computed tomography (CT) may be associated with outcomes after TEER. This study aimed to examine the association between CT features of MAC and clinical outcomes after TEER at 3 years.

Methods
This retrospective observational study was conducted at the Cedars-Sinai Medical Center and included patients who underwent TEER and preprocedural CT. Patients were classified into two groups based on the severity of MAC: no/mild MAC and moderate/severe MAC. Classification was determined by scoring calcium thickness, distribution, trigone involvement, and leaflet calcification. The primary outcome was all-cause mortality 3 years after TEER.

Results
Among 391 patients who underwent pre-TEER cardiac CT, 318 (81.3%) had no/mild MAC, and 73 (18.7%) had moderate/severe MAC. No significant differences were noted in all-cause mortality at 3 years between the groups (17.6% vs. 24.7 %; P = 0.17). However, patients with no/mild MAC had significantly better NYHA class than those with moderate/severe MAC at 3 years (P = 0.029). Calcium thickness > 5 mm and leaflet involvement were significant predictors of all-cause mortality at 3 years (OR: 2.38; 95% CI: 1.08–5.25, p=0.032, OR: 6.71; 95% CI: 3.28–13.7, P < 0.001). Subgroup analysis revealed that patients with both significant leaflet calcification and calcium thickness > 5 mm had significantly higher incidences of all-cause mortality compared to those with average calcium thickness ≤ 5 mm and no leaflet calcification.

Conclusions
All-cause mortality did not significantly differ between patients with no/mild MAC and those with moderate/severe MAC. However, greater calcium thickness and leaflet involvement were associated with worse clinical outcomes in patients undergoing TEER. Detailed preoperative CT evaluation can facilitate the prediction and management of TEER outcomes
  • Nagasaka, Takashi  ( Gunma University Graduate School of , Maebashi , Japan )
  • Nakamura, Mamoo  ( Smidt Heart Institute, Cedars-Sinai , Los Angeles , California , United States )
  • Makkar, Raj  ( Cedar Sinai Medical Center , Los Angeles , California , United States )
  • Patel, Vivek  ( Cedars Sinai Medical Center , Los Aeles , California , United States )
  • Suruga, Kazuki  ( Cedars Sinai Medical Center , Los Aeles , California , United States )
  • Shechter, Alon  ( Rabin Medical Center , Petach Tikva , Israel )
  • Chakravarty, Tarun  ( Cedars Sinai Medical Center , Los Angeles , California , United States )
  • Gupta, Aakriti  ( Cedars-Sinai Medical Center , Los Angeles , California , United States )
  • Ishii, Hideki  ( Gunma University , Maebashi , Japan )
  • Jilaihawi, Hasan  ( Cedars-Sinai Heart Institute , Los Angeles , California , United States )
  • Makar, Moody  ( Cedars Sinai Medical Center , Los Aeles , California , United States )
    • Author Disclosures:
    Takashi Nagasaka: No Answer | Mamoo Nakamura: DO NOT have relevant financial relationships | Raj Makkar: No Answer | Vivek Patel: DO NOT have relevant financial relationships | Kazuki Suruga: DO NOT have relevant financial relationships | Alon Shechter: DO NOT have relevant financial relationships | Tarun Chakravarty: DO have relevant financial relationships ; Consultant:Edwards Lifesciences:Active (exists now) ; Consultant:Medtronic:Past (completed) ; Consultant:Abbott:Past (completed) ; Speaker:Boston Scientific:Active (exists now) ; Consultant:Boston Scientific:Active (exists now) ; Speaker:Edwards Lifesciences:Active (exists now) | Aakriti Gupta: DO have relevant financial relationships ; Consultant:Boston Scientific:Past (completed) | Hideki Ishii: No Answer | Hasan Jilaihawi: No Answer | Moody Makar: DO have relevant financial relationships ; Consultant:abbott vascular:Active (exists now) ; Consultant:edwards lifesciences:Active (exists now) ; Consultant:boston scientific:Active (exists now)
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Mitral Focus: Advances in Mitral Valve Disease Mechanisms and Management

Saturday, 11/08/2025 , 10:30AM - 11:30AM

Abstract Poster Board Session

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