Mitral Annular Calcification and Mitral Valve Replacement: A New Approach  Valérie Lafrenière-Bessi, PhD, Maude Cameron-Gagné, Jean Perron, MD, Marie-Hélène.

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Mitral Annular Calcification and Mitral Valve Replacement: A New Approach  Valérie Lafrenière-Bessi, PhD, Maude Cameron-Gagné, Jean Perron, MD, Marie-Hélène Lévesque, MD, Maxime Laflamme, MD, MSc, Éric Charbonneau, MD, Siamak Mohammadi, MD, Frédéric Jacques, MD, MSc  The Annals of Thoracic Surgery  Volume 105, Issue 2, Pages e55-e57 (February 2018) DOI: 10.1016/j.athoracsur.2017.09.028 Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diagram from a transseptal atrial view showing the mitral valve bioprosthesis anchored to the native uncalcified coronary sinus. The Annals of Thoracic Surgery 2018 105, e55-e57DOI: (10.1016/j.athoracsur.2017.09.028) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Diagram and noncontrast enhanced computed tomography scans showing extensive mitral annular calcification (MAC) and insertion of a no. 31 St. Jude Epic mitral valve bioprosthesis. (A) Left lateral view (two-chamber) of the heart with extensive MAC, cut through the left atrium and left ventricle showing a mitral valve bioprosthesis with fixating pledgets passed into the native uncalcified coronary sinus (CS). (B) Long-axis view of the left ventricle showing MAC, bioprosthesis, and pledgets within the CS. (C) Short-axis view through the atrioventricular junction showing extensive MAC surrounding the titanium ring of the mitral valve bioprosthesis. (D) Short-axis view of the mitral valve showing the titanium ring of the bioprosthesis and two pledgets attached on the roof of the CS. The Annals of Thoracic Surgery 2018 105, e55-e57DOI: (10.1016/j.athoracsur.2017.09.028) Copyright © 2018 The Society of Thoracic Surgeons Terms and Conditions