Unal M, Sanisoğlu I, Konuralp C, Akay H, Orhan G, Aydoğan H, Aka S A, Eren E E
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Tex Heart Inst J. 1996;23(2):85-7.
A heavily calcified heart valve annulus increases the likelihood of sequelae after prosthetic valve replacement. Such sequelae include cerebral embolism, paravalvular leakage, valvular dysfunction, rhythm disturbance, hemolysis, communication of the heart chambers, and rupture of the posterior wall of the left ventricle. From January 1991 through June 1994, we performed heart valve replacement on 30 patients, using an 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 débridement of calcified annuli. All patients were re-examined 6 months after surgery: echocardiographic study showed no paravalvular leakage or valve-related complications. In our experience, ultrasonic decalcification of the annulus is superior to traditional methods. We advocate the use of ultrasonic débridement as an adjunctive tool in calcified heart valve replacement.
严重钙化的心脏瓣膜环增加了人工瓣膜置换术后出现后遗症的可能性。这些后遗症包括脑栓塞、瓣周漏、瓣膜功能障碍、节律紊乱、溶血、心腔相通以及左心室后壁破裂。从1991年1月至1994年6月，我们对30例患者进行了心脏瓣膜置换术，使用超声手术吸引器清除钙化沉积物。在对钙化瓣环进行超声清创后，我们为12例患者植入了主动脉瓣假体，为13例患者植入了二尖瓣假体，为5例患者同时植入了主动脉瓣和二尖瓣假体。所有患者在术后6个月进行了复查：超声心动图检查显示无瓣周漏或与瓣膜相关的并发症。根据我们的经验，瓣环的超声脱钙优于传统方法。我们提倡将超声清创作为钙化心脏瓣膜置换术中的辅助工具。
