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Updated: Jan 23, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
Ultrasonic annular debridement in minimally invasive aortic valve replacement
Toshinori Totsugawa1, Arudo Hiraoka2, Kentaro Tamura2
1Department of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, 2-5-1 Nakai-cho, Kita-ku, Okayama, 700-0804, Japan. toshinoritotsugawa@gmail.com.
Abstract:
Here, we demonstrate the details of annular decalcification using an ultrasonic aspirator in minimally invasive aortic valve replacement for aortic stenosis. In our debridement procedure, the aortic valve leaflets are excised with enough valve tissue left, not just at the annulus. The invisible annulus is exposed by traction of the remnant valve tissue, and the annular calcifications are scraped off using an ultrasonic aspirator. After an annular decalcification, the remnant valve tissue was completely resected using long scissors. No cases of in-hospital mortality, annular injury, stroke, or paravalvular leakage were found. In conclusion, ultrasonic aspirator allowed safe and secure annular debridement and could be a useful tool during minimally invasive aortic valve replacement.
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