تضيق الصمام التاجي التنكسي مع تكلس الحلقة التاجية في المرضى المسنين: ماذا تفعل عندما لا يتمكن العلاج الدوائي من السيطرة على الأعراض

DOI: 10.1093/eurheartj/ehaf194

• Degenerative MS related to MAC is a distinct age-dependent pathology requiring different treatment strategies.
• Patients presenting with MAC are elderly and have significant comorbidities, including disease of other valves.
• Intervention is recommended in symptomatic patients who are not responsive to medical therapy, weighing the potential benefits of the procedure against its associated risks.
• However, surgical MV repair or replacement with extensive decalcification and patch reconstruction of the annulus can be performed in selected patients at experienced centres (e.g. young patients post-chest radiation), where mortality rates of <5% have been reported.
• TMVI may be considered in symptomatic patients with extensive MAC and severe MV dysfunction at experienced Heart Valve Centres with expertise in complex MV surgery and transcatheter interventions.