ARTICLE SUMMARY:
Mitral annular calcification has emerged as a priority in cardiology, as evidence increasingly links the condition to heart failure risk and procedural complications during mitral valve interventions. Bunkerhill Health’s solution enables early, consistent, and scalable identification of the condition. Excerpted from our recent feature article, Attacking MAC.
A growing body of literature argues for proactive identification of mitral annular calcfification, a chronic, degenerative disorder marked by calcium deposition in the mitral annulus. MAC impairs valve function and often leads to mitral regurgitation and ensuing conditions whose treatment becomes significantly more complex in the presence of annular calcification.
Bunkerhill Health is ahead of that curve. The company first drew attention with its FDA-cleared AI solution for detecting and quantifying coronary artery calcium from routine, non-gated chest CT scans performed for non-cardiac indications such as lung cancer screening or pneumonia diagnosis. (See “Cleerly and Bunkerhill Partner to Find Cardiac Patients at Risk,” MedTech Strategist, March 12, 2025.) In October 2025, Bunkerhill reached another milestone, announcing FDA clearance for an AI algorithm that detects and quantifies MAC from those same routine scans.
From routine CT scans, Bunkerhill Health can now identify patients at previously unrecognized risk due to coronary artery calcium, aortic valve calcium (a marker of aortic stenosis), and mitral annular calcification. The company is also developing algorithms to detect carotid artery calcium and an ECG-based model for predicting heart failure.
Bunkerhill’s primary customers are hospitals and insurers rather than specialty practices. Hospitals benefit by channeling previously unseen patients into cardiology service lines, while payors are motivated by the opportunity to prevent costly downstream events. “These algorithms are a slam dunk,” says founder and CEO Nishith Khandwala.Khandwala. “They identify patients cardiology would not have seen otherwise.”
To address concerns around false-positives and operational burden, Bunkerhill built an infrastructure layer called Carebricks. Because calcium is common in older populations—and many such patients are already under cardiology care—Carebricks filters findings through the electronic health record to determine who truly needs follow-up.
Working seamlessly with hospital EHRs, Bunkerhill’s algorithms are automatically triggered when a patient undergoes a CT scan. Generative AI then evaluates clinical context, flags workflow gaps, and checks for duplicative care or contraindications, such as recent cardiology visits or advanced non-cardiac illness. Only patients deemed appropriate for referral trigger automated outreach to both patients and primary care providers via EHR messaging, mail, or text.
Bunkerhill’s growth reflects two converging trends: the continued rise in CT utilization—approximately 20 million non-cardiac CT scans are performed annually in the US—and the emergence of more targeted, minimally invasive cardiovascular therapies, including those for MAC.
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