Ultrasonic Decalcification for Mitral Stenosis with Mitral Annular Calcification:a Case Report

Yuto Narumiya＊	Hideo Yoshida＊	Yu Oshima＊
Yoshimasa Kishi＊	Shohei Yokoyama＊	Kenji Yoshida＊
Munehiro Saiki＊	Atsushi Tateishi＊	Keiji Yunoki＊
Kunikazu Hisamochi＊

（Department of Cardiovascular Surgery, Hiroshima Citizens Hospital of Hiroshima City Hospital Organization＊, Hiroshima, Japan）

Mitral valve surgeries for cases with mitral annular calcification（MAC）are challenging because of the operative complications. For a case of MS with MAC, we achieved mitral valve plasty by ultrasonic decalcification alone. An 82-year-old male with edema and dyspnea was diagnosed with AS and MS with MAC. MAC was so severe that MVR was challenging. There were calcifications at the anterior commissure and the anterior mitral leaflet（AML), and removal of them was expected to improve the valve function. Therefore, anterior commissurotomy and ultrasonic decalcification of the anterior commissural annulus was performed using cavitron ultrasonic surgical aspiration（CUSA). Following the resection of the aortic valve, we carried out decalcification of the AML through the aortic valve orifice. After AVR, a trans-esophageal echocardiogram showed MS was ameliorated. Two years after surgery, recurrence of MS was not recognized. Some mitral cases with MAC can be treated by only decalcification to avoid risky valve replacement.

 

Jpn. J. Cardiovasc. Surg. 49:275-279（2020）

Keywords：MS;MAC;decalcification;ultrasonic device