Related Experiment Videos
Ultrasonic decalcification of calcified cardiac valves and annuli
Insights
An ultrasonic calculus-disintegrator effectively removes calcific deposits from heart valves, reducing complications associated with prosthetic valve replacement. This innovative tool aids in debridement, improving surgical outcomes for calcific aortic stenosis.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Devices
Background:
- Heavily calcified annuli are associated with increased complications during prosthetic valve replacement, including heart block, paravalvular leak, and hemolysis.
- Existing methods for managing calcific deposits can be challenging and may lead to surgical difficulties.
Purpose of the Study:
- To evaluate the efficacy of a newly developed ultrasonic calculus-disintegrator for removing calcific deposits from heart valves.
- To assess the safety and effectiveness of this device in clinical settings, particularly in cases of prosthetic valve replacement and aortic stenosis.
Main Methods:
- Development of a portable, robust, and sterilizable ultrasonic calculus-disintegrator.
- Utilizing nebulized water at the ultrasonic tip for cooling, cavitation-induced calculus breakdown, and debris removal.
- Preliminary trials on excised calcific valves and clinical application in prosthetic valve replacement and aortic valve debridement.
Main Results:
- The ultrasonic instrument demonstrated capability in removing most forms of calcification from excised valves.
- Successful annulus clearance was achieved in six out of seven clinical prosthetic valve replacement cases.
- Two elderly patients with pure calcific aortic stenosis were successfully treated via ultrasound-assisted aortic valve debridement.
Conclusions:
- The ultrasonic calculus-disintegrator is a promising tool for managing calcific deposits in cardiac surgery.
- This device can facilitate prosthetic valve replacement by improving annulus clearance, especially in complex cases.
- Ultrasound-assisted debridement offers a viable treatment option for severe calcific aortic stenosis.
Abstract:
Heavily calcified annuli increase the incidence of complications after prosthetic valve replacement-heart block, separation of the aorta or the atrium from the ventricle, late aneurysm formation, paravalvular leak, and haemolysis. An ultrasonic calculus-disintegrator has been developed to remove calcific deposits. The instrument is portable, robust, easily sterilized, inexpensive, and provides nebulized water at the ultrasonic tip which keeps the tissues cool, helps to break up the calculus by cavitation, and washes the calcific debris into the sucker. Preliminary trial on excised calcific valves showed the ultrasound instrument to be capable of removing most forms of calcification. In clinical prosthetic replacement of valves it enabled good clearance of the annulus to be performed in six out of seven cases, in one of which earlier operation had been unsuccessful because of calcification. Two elderly patients with pure calcific aortic stenosis were successfully treated by debridement of the aortic valve with ultrasound.