The Annals of Thoracic Surgery, Vol 28, 605-606, Copyright © 1979 by The Society of Thoracic Surgeons
A special rongeur for removal of extensively calcified mitral valves
AT Culliford, AD Boyd and FC Spencer
A rare complication of advanced mitral valve disease occurs when calcium
extends from the valve downward along the wall of the left ventricle into
the ventricular cavity. This unusual condition can be recognized on
fluoroscopy because the calcium is visible at right angles to the calcium
in the valve. The surgeon faces a very difficult technical problem because
it is hard to obtain adequate exposure and to remove the calcium without
injury to adjacent tissues or loss of calcific fragments, with resulting
embolization. Such difficulties were encountered a year ago in a patient
undergoing mitral and aortic valve replacement and ultimately resulted in
the patient's death. After this event, the special rongeurs described here
were designed.