PIEZOELECTRIC-ASSISTED AORTIC VALVE REPAIR

Several techniques of aortic valve (AV) repair have shown safety and efficacy. One of the main contraindications to AV repair is still the presence of cusps calcification. Piezoelectric effect can be used to selectively cut calcium while sparing surrounding soft tissues addressing also complex valves with calcified cusps. Here we present a case of a 55-year-old woman with diagnosis of severe AV regurgitation and dilated ascending aorta who was suitable for aortic valve repair. The trans-esophageal echocardiography (TEE) showed a tricuspid AV with severe regurgitation and a partial fusion of right and non-coronary cusps with mild calcification of the raphe, which could compromise a successful repair. The raphe was shaved with a piezoelectric scalpel until a pliable surface was obtained and post-procedural TEE showed a trivial residual AV regurgitation. This tool can help surgeons to face also complex cases considered not suitable for a conservative technique.