title: Ultrasonic decalcification of calcified valve and annulus during heart valve replacement.
abstract: A heavily calcified heart valve annulus increases the likelihood of sequelae after prosthetic valve replacement. Such sequelae include cerebral embolism, paravalvular leakage, valvular dysfunction, rhythm disturbance, hemolysis, communication of the heart chambers, and rupture of the posterior wall of the left ventricle. From January 1991 through June 1994, we performed heart valve replacement on 30 patients, using an ultrasonic surgical aspirator to remove calcific deposits. We placed aortic valve prostheses in 12 patients, mitral valve prostheses in 13 patients, and both aortic and mitral prostheses in 5 patients, after ultrasonic débridement of calcified annuli. All patients were re-examined 6 months after surgery: echocardiographic study showed no paravalvular leakage or valve-related complications. In our experience, ultrasonic decalcification of the annulus is superior to traditional methods. We advocate the use of ultrasonic débridement as an adjunctive tool in calcified heart valve replacement.
authors.affiliation: Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Unal
authors.forename: I
authors.initials: I
authors.lastname: Sanisoğlu
authors.forename: C
authors.initials: C
authors.lastname: Konuralp
authors.forename: H
authors.initials: H
authors.lastname: Akay
authors.forename: G
authors.initials: G
authors.lastname: Orhan
authors.forename: H
authors.initials: H
authors.lastname: Aydoğan
authors.forename: S A
authors.initials: SA
authors.lastname: Aka
authors.forename: E E
authors.initials: EE
authors.lastname: Eren
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D002114:Calcinosis / Q000628:therapy*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D014464:Ultrasonic Therapy / Q000379:methods*