Mitral and aortic valve decalcification by ultrasonic energy

Eguaras, Manuel G.; Saceda, Jose Luis; Luque, Inmaculada; Concha, Manuel

doi:10.1016/s0022-5223(19)35672-7

Cited by 24 publications

(7 citation statements)

References 4 publications

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“…The excursion of our tip was 110 μm comparatively to the 154 μm excursion of the Cavitron ® used by McBride [ 7 ]. As the Penstyle ® handpiece decalcifies in better conditions than those previously described [ 8 ], with a lower level of mechanical energy, we expected a decreased healing response and consequently a decreased occurrence of aortic insufficiency. There is not any biological effects of our ultrasounds on the normal tissue, therefore we can use our probe safely in a therapeutic approach.…”

Section: Discussionmentioning

confidence: 74%

A new ultrasonic process for a renewal of aortic valve decalcification

Aubert

Voiglio²,

Chalabreysse

et al. 2006

Cardiovasc Ultrasound

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BackgroundAortic valve decalcification by ultrasound was given up. We evaluated a new ultrasound microhandpiece (Dissectron Penstyle®) to rehabilitate this alternative treatment.MethodsWe used under magnifying lenses the ultrasound microhandpiece to decalcify 30 explanted aortic valves. In the cases with embedded calcifications the thin top of the probe could be introduced into the thickness of the leaflet preserving covering layers.ResultsThe leaflets were totally decalcified and flexible, and surrounding structures were preserved as assessed by histological examination.ConclusionThis new approach of ultrasonic aortic valve decalcification gives good in vitro results which allow to consider a clinical evaluation of this procedure.

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Section: Discussionmentioning

confidence: 74%

A new ultrasonic process for a renewal of aortic valve decalcification

Aubert

Voiglio²,

Chalabreysse

et al. 2006

Cardiovasc Ultrasound

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“…Other devices employing the same principles are Ultra ultrasonic aspirators (Sharplan Lasers, Inc., Needham, MA, USA), Sonotec ME 2000 and ME 2100 (Sumitomo Corp., Tokyo, Japan) and Dr. Loschilov's URSK7N (developed in Moscow, Russia, and reported from Moscow and Kaunas, Lithuania). [2][3][4][5][6][7][8][9] These ultrasonic aspirators (USAs) vibrate at 23 kHz to fragment tissue and they require coaxial irrigation with a powerful aspiration device to remove cellular debris and water. A tip-cooling system is essential.…”

Section: Magnetostrictive Aspiratorsmentioning

confidence: 99%

“…1 Both in-vitro and in-vivo decalcification of valve leaflets and annuli have been performed with CUSA, Sonocor, and other devices. [7][8][9][10] Renewed clinical interest in ultrasonic debridement, especially in senile aortic valve disease, in several centers in the late 1980s and early 1990s, led to satisfactory early results in reduction of transvalvular gradients but disappointing late outcome due to aortic cuspal retraction and progressive aortic regurgitation. [25][26][27][28][29][30][31][32][33][34] Such changes may be due to a higher ultrasonic power setting and aggressive application for longer duration.…”

Section: Cardiac Surgical Applicationsmentioning

confidence: 99%

“…1 Current use of these devices in cardiovascular surgery has developed mostly in the last decade. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Earlier, water-cooled ultrasonic aspirators with magnetostrictive transducers were used to fragment and aspirate calcium, fat, and soft tissues. Subsequently, ultrasonic aspirators were modified, employing a piezoelectric ceramic electrostrictive transducer that required no cooling and these have been used in coronary artery surgery.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonic Devices in Cardiac Surgery

Ghosh¹

1999

Asian Cardiovasc Thorac Ann

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Recent innovations in ultrasonic devices include high-frequency coagulating shears with piezoelectric ceramic electrostrictive transducers for both open and endoscopicprocedures. Various ultrasonic devices have been used for the dissection of internal mammary, radial, and gastroepiploic arteries, aortic root, proximal right coronary artery, and left main coronary artery, as well as prior to surgical coronary ostial reconstruction and for elimination of stenotic induration in coronary arteries, release of muscle bridges, exposure of deep-seated coronary arteries, pericardiectomy, and removal of a cardiac tumor. Unlike valve decalcification, the required energy output of ultrasonic aspirators in coronary artery surgery is much lower and harvesting time of arterial conduits is significantly shortened. Ultrastructural studies of harvested internal mammary artery segments with scanning and transmission electron microscopy revealed no structural alteration of the wall or luminal surface when low energy output was used for dissection. On direct application of higher energy, subendothelial blistering may be detected occasionally. Ultrasonic devices help to remove thick fatty tissue and muscle bridges with almost no bleeding. Use of these devices may facilitate precise coronary artery surgery.

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“…Techniques to avoid or directly manage calcified annular debris include placing sutures around1 or through calcific bars,* suturing the prosthesis to the mitral leaflets instead of the annulus,a enblock excision of the calcific bar,4 or ultrasonic decalcification of the anulus. [4][5][6][7] We previously reported the use of the Cavitron Ultrasonic Surgical Aspirator (CUSA, Cavitron Surgical Systems Inc., Stanford, CT, USA) for decalcification of the aortic valve annul~s*~g with good results and herein report our experience with the less frequently used modality of ultrasonic decalcification of mitral annular and leaflet calcification.…”

Section: Calcified Mitral Valve (J Card Surg 7997; 72:24o-242)mentioning

confidence: 99%

Ultrasonic Debridement of Mitral Calcification

et al. 1997

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Dense annular calcification to the valve attachment is particularly hazardous during mitral valve replacement because of the difficulty of placing sutures and the risk of atrioventricular rupture. We report 11 patients who underwent decalcification of the mitral anulus with the Cavitron Ultrasound Surgical Aspirator (CUSA) during mitral valve replacement. This resulted in a greatly simplified suture placement and prosthetic valve seating as well as enlargement of the annular orifice. Four other patients underwent CUSA debridement of the anterior leaflet of the mitral valve during concomitant aortic valve replacement and CUSA debridement of the aortic anulus. There were no operative deaths or major complications. Ultrasonic debridement is a useful adjunct in the surgical management of the heavily calcified mitral valve.

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Mitral and aortic valve decalcification by ultrasonic energy

Cited by 24 publications

References 4 publications

A new ultrasonic process for a renewal of aortic valve decalcification

A new ultrasonic process for a renewal of aortic valve decalcification

Ultrasonic Devices in Cardiac Surgery

Ultrasonic Debridement of Mitral Calcification

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