Abstract

Extensive mitral annular calcification (MAC) can represent a significant surgical challenge. We use three illustrative examples to describe our early experience with electrocardiogram-gated cardiac computed tomography (CT) as a preoperative tool to localize MAC and to predict requisite surgical techniques. In all three cases, cardiac CT accurately delineated the location and extent of calcification compared with intraoperative findings, and in each case, it assisted in predicting the required operation (avoidance vs resection of calcification; need for annular reconstruction). All 3 patients experienced an uneventful postoperative course with no evidence of paravalvular leak on follow-up echocardiography.

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