Khalil, Ibrahim

Makkinejad, Alexander

McFarland, Mary

Patel, Puja, MD

Patel, Sakshi

Wu, James K., MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health Network LVHN Scholarly Works Research Scholars Outcomes of Ultrasonic Aspirator Use for MAC Debridement in Mitral Valve Replacement Surgery Sakshi Patel Ibrahim Khalil Mary McFarland Alexander Makkinejad Puja Patel MD See next page for additional authors Follow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars  Part of the Medicine and Health Sciences Commons This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact LibraryServices@lvhn.org. Authors Sakshi Patel, Ibrahim Khalil, Mary McFarland, Alexander Makkinejad, Puja Patel MD, and James K. Wu MD Lehigh Valley Health Network, Allentown, Pennsylvania• Mitral annular calcification (MAC): calcium deposits on the mitral valve annular ring à hinder surgeon’s abilities to secure sutures for replacement and repair surgical devices  • Severe MAC is associated with higher mortality and morbidity rates for MVR patients.4,5• The ultrasonic aspirator focuses low-frequency ultrasound vibrations on the calcium bar, creating fragments that can be aspirated while protecting surrounding normal tissue. BackgroundMethodsResults ConclusionsRecommendationsOutcomes of Ultrasonic Aspirator Use for MAC Debridement in Mitral Valve Replacement SurgerySakshi Patel, Ibrahim Khalil, Mary McFarland, Alexander Makkinejad, BS, Puja Patel, MD, James K. Wu, MDLehigh Valley Heart and Vascular Institute, LVPG Cardiac and Thoracic Surgery, Division of Cardiothoracic Surgery retrospective review of patients with ultrasonic aspirator use from 2019-2022 at LVHNObjective Determine the affects of severe MAC debridement using a surgical aspirator on survival rates in MVR patients (n=37)ReferencesCreate a REDCap database to record patient information such as past surgical/medical history, pre-op and post-op valve conditions, and survival rates Use descriptive statistics to evaluate patient survival rates1. 2. 3. Figure 7: Kaplan Meier curve of MVR patients with ultrasonic aspirator use 30 days after surgery  • 37 total patients• 5 died (13.9%) • Average patient age at time of surgery: 70.36 years Figure 4 (above): Pre-op Mitral Valve Disease conditionsFigure 5 (right): Severity grading of pre-op mitral valve conditions. Figure 6 (bottom): chart to determine severity grading of mitral stenosis Figure 1: left-sided heart, showing mitral valve Figure 2: echocardiogram showing MAC Figure 3: x-ray showing MAC Further studies can be performed to compare patients with ultrasonic aspirator debridement to patients without ultrasonic MAC debridement. The study can explore the presence of left atrioventricular groove injury and survival rates in both groups. • Patients more commonly presented with mitral regurgitation pre-op, compared to mitral stenosis.• Patients with ultrasonic aspirator use are most vulnerable one-week post-op as that period have the greatest drops in survival rates. • There have been no operative deaths or post-op complications found due to the ultrasonic aspirator from this study. • Future research should evaluate long-term outcomes after five and ten years to better understand long-term survival rates. 1. Baumgartner, F.J., Pandya, A., Omari, B.O., Pandya, A., Turner, C., Milliken, J.C. and Robertson, J.M. (1997), Ultrasonic Debridement of Mitral Calcification. Journal of Cardiac Surgery, 12: 240-242. https://doi.org/10.1111/j.1540-8191.1997.tb00133.x2. Fasol R, Mahdjoobian K, Joubert-Hubner E. Mitral repair in patients with severely calcified annulus: feasibility, surgery and results. J Heart Valve Dis. 2002 Mar;11(2):153-9. PMID: 12000153.3. Feindel CM, Tufail Z, David TE, Ivanov J, Armstrong S. Mitral valve surgery in patients with extensive calcification of the mitral annulus. J Thorac Cardiovasc Surg. 2003 Sep;126(3):777-82. doi: 10.1016/s0022-5223(03)00081-3. PMID: 14502154.4. Kaneko T, Hirji S, Percy E, Aranki S, McGurk S, Body S, Heydarpour M, Mallidi H, Singh S, Pelletier M, Rawn J, Shekar P. Characterizing Risks Associated With Mitral Annular Calcification in Mitral Valve Replacement. Ann Thorac Surg. 2019 Dec;108(6):1761-1767. doi: 10.1016/j.athoracsur.2019.04.080. Epub 2019 Jun 15. PMID: 31207248.5. Uchimuro T, Fukui T, Shimizu A, Takanashi S. Mitral Valve Surgery in Patients With Severe Mitral Annular Calcification. Ann Thorac Surg. 2016 Mar;101(3):889-95. doi: 10.1016/j.athoracsur.2015.08.071. Epub 2015 Nov 3. PMID: 26545623.

Outcomes of Ultrasonic Aspirator Use for MAC Debridement in Mitral Valve Replacement Surgery

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Outcomes of Ultrasonic Aspirator Use for MAC Debridement in Mitral Valve Replacement Surgery

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