M. Unal et al., ULTRASONIC DECALCIFICATION OF CALCIFIED VALVE AND ANNULUS DURING HEART-VALVE REPLACEMENT, Texas Heart Institute journal, 23(2), 1996, pp. 85-87
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.