{"doi":"10.1016/j.jtcvs.2024.10.022","title":"Effects of mitral calcification in severe aortic stenosis with severe mitral regurgitation on left heart remodeling, surgical strategy, and outcomes","abstract":"OBJECTIVE: To localize and quantify mitral calcification associated with severe aortic stenosis and severe mitral regurgitation and determine its association with cardiac remodeling, operative management, and long-term survival. METHODS: Between July 1998 and July 2010, 158 patients with severe aortic stenosis, severe mitral regurgitation, and mitral calcification underwent surgical aortic valve replacement (SAVR; n = 49) or SAVR plus mitral valve repair (SAVR+MVr; n = 67) or replacement (SAVR+MVR; n = 42) at our institution. Mitral calcium was localized and quantified by a preoperative computed tomography (CT) scan. Random forest methodology was used to correlate calcium volume with cardiac morphology and function. The median follow-up for survival was 4.1 years; 25% of patients were followed for ≥14 years. RESULTS: ). Ten-year mortality was higher in patients with more mitral calcification (terciles: 7.1% vs 16% vs 25%), subvalvular involvement (8.1% vs 18%), and SAVR+MVR (5.4% vs SAVR; 13% vs SAVR+MVr = 26%). Multivariable analysis showed that early postoperative mortality was strongly associated with subvalvular mitral calcification, but late mortality was not associated with calcium volume or location. CONCLUSIONS: Greater mitral calcium volume is a marker of late-stage cardiac remodeling associated with more extensive mitral valve intervention but not with long-term mortality. Quantitative analysis of mitral calcification with CT can aid patient selection and surgical management decisions in this complex patient population.","journal":"Journal of Thoracic and Cardiovascular Surgery","year":2024,"id":450807,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9267,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1271785,"name":"Monica Isabella","orcid":null,"position":1,"is_corresponding":false},{"id":1271292,"name":"Leonardo Rodríguez","orcid":"0000-0002-7956-9878","position":2,"is_corresponding":false},{"id":1095642,"name":"Paul D. Bishop","orcid":null,"position":3,"is_corresponding":false},{"id":1271293,"name":"Nicholas G. Smedira","orcid":"0000-0002-4963-8588","position":4,"is_corresponding":false},{"id":1271786,"name":"Jeevanantham Rajeswaran","orcid":null,"position":5,"is_corresponding":false},{"id":1271787,"name":"Benjamin P. Kramer","orcid":null,"position":6,"is_corresponding":false},{"id":917215,"name":"Ashley M. Lowry","orcid":"0000-0001-9578-6859","position":7,"is_corresponding":false},{"id":1271788,"name":"Eugene H Blackstone","orcid":null,"position":8,"is_corresponding":false},{"id":514676,"name":"Eric E. Roselli","orcid":"0000-0003-1533-7987","position":9,"is_corresponding":false},{"id":932759,"name":"Abigail Snyder","orcid":"0000-0002-5006-3400","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:02:28.969209Z","pmid":"39442864","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}