title: Aortic and mitral annular remodeling using ultrasonic decalcification.
abstract: Mitral and particularly aortic valve replacements may be complicated by heavy calcification of the anulus, markedly impairing proper valve seating. From 1987 to 1996, we have used ultrasonic energy with the CUSA-device in valvular replacement to debride the aortic anulus in 90 patients and the mitral anulus in 2 patients. Annular debridement using ultrasonic decalcification is superior to other methods of debridement because it is safer, more thorough, and affords improved seating of the valve. As a result, placement of a larger valve is possible within a more compliant, wider anulus. There have been 0% incidence of paravalvular leak or valve failure. The operative mortality in our series was 1/92 (1.1%). Other than the fatality, the incidence of permanent stroke was 0%. Ultrasonic debridement to remodel the aortic and mitral valve anulus has been an invaluable adjunct in the heavily calcified anulus.
authors.affiliation: Division Cardio-Thoracic Surgery, Harbor UCLA Medical Center, USA.
authors.forename: F
authors.initials: F
authors.lastname: Baumgartner
authors.forename: P
authors.initials: P
authors.lastname: Pearsall
authors.forename: K
authors.initials: K
authors.lastname: Omari
authors.forename: J
authors.initials: J
authors.lastname: Robertson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D002114:Calcinosis / Q000401:mortality / Q000601:surgery*; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000401:mortality; D003646:Debridement / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D013396:Suction / Q000295:instrumentation*; D015996:Survival Rate; D014464:Ultrasonic Therapy / Q000295:instrumentation*