Mitral valve surgery in annulus calcification (Figs. 3–8)

Abstract

Marked calcification of the mitral annulus impairs its motion during the cardiac cycle. Dense calcification of the entire submitral region, in its most severe form, is characterized by the development of a rigid curved ring of calcium that encircles the mitral orifice. Ramifications of these calcifications, so-called calcific spurs, often project into the adjacent left ventricular myocardium (Fig. 3.1–8) . The calcification may also affect the basal portions of the valve leaflet and cause distortion of the posterior mitral valve leaflet with limitation of motion. The base of the posterior mitral valve leaflet is pushed towards the atria, often stimulating a degree of mitral prolapse. This may result in insufficient leaflet area for coaptation, eventually leading to valve insufficiency which, if untreated, may result in cardiac failure.