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Early and Intermediate Outcomes of Cavitron Ultrasonic Surgical Aspiration to Treat Mitral Annular Calcification

Wendy Jin1,2, Sabet W Hashim1, Raymond G Mckay1

  • 1Cardiac Surgery, Hartford Healthcare Heart and Vascular Institute, Hartford, CT, 06106, United States.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 6, 2026
PubMed
Abstract

Insights

Cavitron ultrasonic surgical aspiration (CUSA) effectively debrides severe mitral annular calcification (MAC) during valve surgery. This method offers acceptable short-term outcomes and durable intermediate-term results for high-risk patients.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Valve Surgery
  • Mitral Valve Disease

Background:

  • Severe mitral annular calcification (MAC) increases perioperative risks in mitral valve surgery.
  • MAC can be a prohibitive risk factor for surgical intervention.

Purpose of the Study:

  • To evaluate the safety and efficacy of Cavitron ultrasonic surgical aspiration (CUSA) for debriding severe MAC.
  • To assess short-term and intermediate-term outcomes in patients undergoing mitral valve surgery with CUSA-assisted MAC debridement.

Main Methods:

  • A cohort of 67 consecutive patients with severe MAC underwent mitral valve repair or replacement using CUSA.
  • Surgical procedures included valve replacement, repair, and combined procedures with or without coronary bypass.
  • Outcomes assessed included 30-day morbidity/mortality and intermediate-term survival via Kaplan-Meier analysis.

Main Results:

  • 30-day mortality was 6.0%, stroke rate was 3.0%, and new atrial fibrillation occurred in 29.0%.
  • No atrioventricular groove ruptures were reported.
  • Intermediate-term all-cause mortality was 9.0% at a mean follow-up of 42.5 months, with 3.0% moderate paravalvular leak.

Conclusions:

  • CUSA debridement of severe MAC during mitral valve surgery is associated with acceptable short-term morbidity and mortality.
  • The technique demonstrates durable intermediate-term results.
  • CUSA facilitates surgical intervention for patients with prohibitive surgical risk due to severe MAC.
Keywords:
Cavitron ultrasonic surgical aspirationmitral annular calcificationmitral regurgitationmitral stenosis

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