Abstract 12439: A Systematic Review on the Management and Outcomes of Patients With Mitral Annular Calcification Thrombus
Bibliographic record
Abstract
Introduction: Mitral annular calcification (MAC) is a common chronic degenerative process of the mitral valve. Thrombus formation on MAC is a rare complication that is poorly understood and likely contributes to the increased risk of thromboembolic events. We performed a systematic review (PROSPERO 2022 CRD42022299281) to understand the management and outcomes of patients with thrombus on MAC. Methods: Medline, Embase, and Cochrane databases (inception to December 2021) were searched to identify studies with MAC thrombus. Patients with prior mitral valve intervention or prosthesis were excluded. The outcomes of interest were treatment, mortality, and thromboembolic events. Results: Fifteen studies with 22 cases of MAC thrombus were included (Table 1). The average age at diagnosis was 69.1±14.8 years and 82% were female. Most patients presented with stroke or transient ischemic event (68%) or myocardial infarction (18%). All patients were diagnosed with either transthoracic (82%) or transesophageal (18%) echocardiography. Seventy-seven percent of patients were treated with anticoagulation alone and 23% required surgery. The most common indication for surgery was prevention of recurrent embolization (14%). No mortality was reported. Thromboembolic events after diagnosis occurred in 27%. For those treated with anticoagulation alone, 23% had persistent thrombus with or without embolization. Conclusions: This is the first systematic review examining the management and outcomes of patients with MAC thrombus. In patients with MAC who present with a thromboembolic event, careful echocardiographic assessment of MAC to exclude the presence of thrombus should be performed. While most patients can be managed with anticoagulation alone, a significant number will require surgery. Persistent thrombus despite anticoagulation and recurrent embolization are common. Larger studies are needed to elucidate the optimal long-term care for these patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".