Baumgartner F, Pearsall P, Omari K, Robertson J
Division Cardio-Thoracic Surgery, Harbor UCLA Medical Center, USA.
Herz. 1996 Jun;21(3):179-82.
Mitral and particularly aortic valve replacements may be complicated by heavy calcification of the anulus, markedly impairing proper valve seating. From 1987 to 1996, we have used ultrasonic energy with the CUSA-device in valvular replacement to debride the aortic anulus in 90 patients and the mitral anulus in 2 patients. Annular debridement using ultrasonic decalcification is superior to other methods of debridement because it is safer, more thorough, and affords improved seating of the valve. As a result, placement of a larger valve is possible within a more compliant, wider anulus. There have been 0% incidence of paravalvular leak or valve failure. The operative mortality in our series was 1/92 (1.1%). Other than the fatality, the incidence of permanent stroke was 0%. Ultrasonic debridement to remodel the aortic and mitral valve anulus has been an invaluable adjunct in the heavily calcified anulus.
二尖瓣置换术，尤其是主动脉瓣置换术，可能因瓣环严重钙化而变得复杂，这会显著影响瓣膜的正确就位。1987年至1996年期间，我们在瓣膜置换术中使用超声能量结合CUSA设备对90例患者的主动脉瓣环和2例患者的二尖瓣环进行清创。使用超声脱钙进行瓣环清创优于其他清创方法，因为它更安全、更彻底，并且能改善瓣膜的就位情况。因此，在更顺应性、更宽的瓣环内可以植入更大的瓣膜。瓣周漏或瓣膜功能障碍的发生率为0%。我们系列中的手术死亡率为1/92（1.1%）。除了死亡病例外，永久性中风的发生率为0%。超声清创重塑主动脉瓣和二尖瓣瓣环，对于严重钙化的瓣环来说是一项非常宝贵的辅助手段。
