Brown A H, Davies P G
Br Med J. 1972 Jul 29;3(5821):274-7. doi: 10.1136/bmj.3.5821.274.
Heavily calcified annuli increase the incidence of complications after prosthetic valve replacement-heart block, separation of the aorta or the atrium from the ventricle, late aneurysm formation, paravalvular leak, and haemolysis. An ultrasonic calculus-disintegrator has been developed to remove calcific deposits. The instrument is portable, robust, easily sterilized, inexpensive, and provides nebulized water at the ultrasonic tip which keeps the tissues cool, helps to break up the calculus by cavitation, and washes the calcific debris into the sucker. Preliminary trial on excised calcific valves showed the ultrasound instrument to be capable of removing most forms of calcification. In clinical prosthetic replacement of valves it enabled good clearance of the annulus to be performed in six out of seven cases, in one of which earlier operation had been unsuccessful because of calcification. Two elderly patients with pure calcific aortic stenosis were successfully treated by debridement of the aortic valve with ultrasound.
严重钙化的瓣环会增加人工瓣膜置换术后并发症的发生率，如心脏传导阻滞、主动脉或心房与心室分离、晚期动脉瘤形成、瓣周漏和溶血。已开发出一种超声结石粉碎机来清除钙化沉积物。该仪器便于携带、坚固耐用、易于消毒、价格低廉，并且在超声探头处提供雾化水，可使组织保持凉爽，通过空化作用帮助分解结石，并将钙化碎片冲洗到吸盘中。对切除的钙化瓣膜进行的初步试验表明，该超声仪器能够清除大多数形式的钙化。在临床瓣膜置换术中，该仪器在七例中有六例能够很好地清除瓣环，其中一例早期手术因钙化而未成功。两名患有单纯钙化性主动脉瓣狭窄的老年患者通过超声清创主动脉瓣成功得到治疗。
