HEART INSTITUTE MINISTRY OF HEALTH OF UKRAINE, KYIV, UKRAINE.
Wiad Lek. 2022;75(3):732-734.
Aortic stenosis (AS) - a constantly progressing disease characterized by thickening and calcification of leaflets of the valve, which leads to obstruction of the blood outflow from the left ventricular (LV), inadequate cardiac output, heart failure, and even sudden death. Prevalence of stenosis consistently increases with age, 0.2% incidence observes in the 50-59 year cohort of patients and almost 10% in patients from the 80-89 year cohort. We report the case of a 78-year-old man who presented with severe aortic valve stenosis. Since conventional valve replacement was problematic because of a small annular diameter we performed ultrasonic aortic valve decalcification. As a result, the systolic pressure gradient across the aortic valve decreased from 106 mm Hg to 22 mm Hg. Our case demonstrated that even in modern era ultrasonic aortic valve decalcification can be an effective option for restoration of mobility of the aortic valve cusps. We advocate the use of it for elderly patients with small aortic annulus in which surgical or transcatheter valve replacement, valve reconstruction could be extremely difficult or unavailable and consider ultrasonic valve decalcification as an additional tool in cardiac surgeon's hands.
主动脉瓣狭窄（AS） - 一种不断进展的疾病，其特征为瓣叶的增厚和钙化，导致左心室（LV）的血液流出受阻、心输出量不足、心力衰竭，甚至猝死。狭窄的患病率随着年龄的增长而持续增加，在 50-59 岁的患者队列中发病率为 0.2%，在 80-89 岁的患者队列中几乎为 10%。我们报告了一位 78 岁男性的病例，其表现为严重的主动脉瓣狭窄。由于环形直径较小，传统的瓣膜置换术存在问题，因此我们进行了超声主动脉瓣去钙化术。结果，主动脉瓣跨瓣收缩压梯度从 106mmHg 降至 22mmHg。我们的病例表明，即使在现代，超声主动脉瓣去钙化术也可以成为恢复主动脉瓣瓣叶活动度的有效选择。我们主张将其用于老年患者，这些患者的主动脉瓣环较小，外科或经导管瓣膜置换术、瓣膜重建可能非常困难或无法进行，我们将超声瓣膜去钙化术视为心脏外科医生手中的附加工具。
