Bar calcification of the mitral anulus. A risk factor in mitral valve operations.

Between Jan. 1, 1979, and Jan. 1, 1986, 72 septuagenarians had open heart operations for disease of the mitral valve. Thirty-two (44%) had additional operative procedures. Overall seven patients (9.7%) died within 30 days of operation. Eleven patients had bar calcification of the posterior mitral annulus as defined by three criteria and 61 did not. No differences between these two groups were present except for hospital mortality. Three of the 11 patients (27.3%) died at or soon after operation of complications resulting from the calcified annular bar. Only four of 61 patients (6.6%) without bar calcification died early. The difference in early mortality between the two groups is significant (p less than 0.05) and identifies the presence of bar calcification of the posterior mitral annulus as an independent risk factor of mitral valve operations in elderly patients.