Ultrasonic Emulsification of Severe Mitral Annular Calcification to Enable Mitral Valve Repair

Mitral annular calcification (MAC) complicates mitral valve surgery and often necessitates mitral valve replacement (MVR) due to challenges in valvular repair. Traditional methods for addressing MAC involve extensive debridement, which can increase perioperative risks. This report explores an innovative technique using ultrasonic emulsification with the Sonopet Qi device to decalcify the mitral annulus allowing successful mitral valve repair in a patient with severe MAC. The case involves a 53-year-old woman with significant mitral regurgitation and severe MAC, who was initially planned for traditional posterior bar decalcification. However, ultrasonic emulsification was chosen to minimize risks associated with traditional debridement methods. This technique uses ultrasonic waves to fragment and aspirate calcium while preserving surrounding tissues and reducing embolic risks. Compared to conventional methods, ultrasonic emulsification offers precise debridement with potentially fewer complications. This case demonstrates that ultrasonic emulsification can be a valuable addition to surgical strategies for MAC, potentially reducing perioperative risks and enabling complex mitral valve repair.