Ultrasonic decalcification of the aortic annulus during aortic valve replacement

Sheppard, Barry; Milliken, Jeffrey C.; Nelson, Ronald J.; Follette, David M.; Robertson, John M.

doi:10.1016/0003-4975(91)91419-v

Cited by 5 publications

(2 citation statements)

References 7 publications

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“…Sheppard et al reported the utility of decalcifi cation using an ultrasonic surgical aspirator for AVR in patients with annular calcifi cation, which may facilitate easy, safe enlargement of the annulus and improved prosthetic valve fi tting. 13 The patients included in this study were elderly, with a mean age of 73 years. They were thought to be at high risk for surgery because they had severe annular calcification.…”

Section: Discussionmentioning

confidence: 99%

Aortic valve replacement with 17-mm St. Jude Medical Regent prosthetic valves for a small calcified aortic annulus in elderly patients

Taniguchi

Noguchi

Onohara

et al. 2010

Gen Thorac Cardiovasc Surg

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Section: Discussionmentioning

confidence: 99%

Aortic valve replacement with 17-mm St. Jude Medical Regent prosthetic valves for a small calcified aortic annulus in elderly patients

Taniguchi

Noguchi

Onohara

et al. 2010

Gen Thorac Cardiovasc Surg

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“…[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. Current majority opinion favors ultrasonic application for aortic annular decalcification only prior to aortic valve replacement.…”

Section: Cardiac Surgical Applicationsmentioning

confidence: 99%

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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