Williamson W A, Aretz H T, Weng G, Shahian D M, Hamilton W M, Pankratov M M, Shapshay S M
Department of Thoracic and Cardiovascular Surgery, Lahey-Clinic Medical Center, Burlington, Massachusetts 01805.
Lasers Surg Med. 1993;13(4):421-8. doi: 10.1002/lsm.1900130405.
This study was designed to compare the efficacy of the erbium:yttrium-scandium-gallium-garnet (Er:YSGG) laser and the holmium:yttrium-aluminum-garnet (Ho:YAG) lasers in debriding calcium from freshly explanted aortic valve leaflets and to compare the Er:YSGG laser with the Cavitron ultrasonic surgical aspirator (CUSA). Aortic valve leaflets were freshly explanted from patients undergoing aortic valve replacement for aortic stenosis. Initially, 4 leaflets each were debrided with the Er:YSGG and the Ho:YAG lasers to attempt removal of calcium deposits while preserving the underlying integrity of the leaflets and minimizing thermal damage. The Er:YSGG laser was more effective in doing so with less thermal and photoacoustic damage when compared with the Ho:YAG laser. Twelve more leaflets each were then debrided with the Er:YSGG laser and the CUSA. The Er:YSGG laser again proved less injurious to the underlying leaflet. The CUSA-treated leaflets demonstrated shattering and disruption of adjacent tissue as well as collagen fiber exposure. These changes were not seen with the Er:YSGG laser. Because of these properties, the Er:YSGG laser merits further evaluation as a tool for aortic valvuloplasty procedures in selected patients with senescent calcific aortic stenosis.
钇-钪-镓-石榴石（Er:YSGG）激光和钬：钇-铝-石榴石（Ho:YAG）激光从新鲜取出的主动脉瓣叶中清除钙的效果，并将Er:YSGG激光与Cavitron超声手术吸引器（CUSA）进行比较。主动脉瓣叶取自因主动脉瓣狭窄接受主动脉瓣置换术的患者。最初，分别用Er:YSGG激光和Ho:YAG激光对4个瓣叶进行清创，试图在保留瓣叶基本完整性并将热损伤降至最低的同时去除钙沉积物。与Ho:YAG激光相比，Er:YSGG激光在这方面更有效，热损伤和光声损伤更小。然后，分别用Er:YSGG激光和CUSA对另外12个瓣叶进行清创。Er:YSGG激光再次证明对下层瓣叶的损伤较小。CUSA处理的瓣叶显示出相邻组织的破碎和破坏以及胶原纤维暴露。而Er:YSGG激光处理的瓣叶未出现这些变化。由于这些特性，Er:YSGG激光作为一种用于特定老年钙化性主动脉瓣狭窄患者主动脉瓣成形术的工具值得进一步评估。
