ULTRASONIC DECALCIFICATION OF CALCIFIED VALVE AND ANNULUS DURING HEART-VALVE REPLACEMENT

A heavily calcified heart valve annulus increases the likelihood of se quelae after prosthetic valve replacement. Such sequelae include cereb ral embolism, paravalvular leakage, valvular dysfunction, rhythm distu rbance, hemolysis, communication of ?he heart chambers, and rupture of the posterior wall of the left ventricle. From January 1991 through J une 1994, we performed heart valve replacement on 30 patients, using a n 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 debridement of calcified annuli. Ail patients were re-exami ned 6 months after surgery: echocardiographic study showed no paravalv ular leakage or valve-related complications. In our experience, ultras onic decalcification of the annulus is superior to traditional methods . We advocate the use of ultrasonic debridement as an adjunctive tool in calcified heart valve replacement.