Evidence mapPaperPMID 41383191Full record

ArticleAnnals of cardiothoracic surgery2025

Ultrasonic emulsification to facilitate mitral valve reconstruction in mitral annular calcification.

Mathieu Rheault-Henry, Mohsyn Imran Malik, Nitish Bhatt, Jill Gelinas, Michael W A Chu

Abstract read
In one paragraph

Article in Annals of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mathieu Rheault-HenryDivision of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada.
Mohsyn Imran MalikDivision of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada.
Nitish BhattDivision of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada.
Jill GelinasDivision of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada.
Michael W A ChuDivision of Cardiac Surgery, Department of Surgery, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Mitral annular calcification (MAC) increases the complexity and risk of mitral valve surgery, often limiting repair feasibility. This study evaluates the early outcomes of ultrasonic emulsification and aspiration using a novel device to facilitate mitral valve repair. Methods: We conducted a prospective, single-centre, single-surgeon series of 27 consecutive patients with moderate-to-severe MAC and degenerative mitral regurgitation (MR) undergoing Sonopet-assisted decalcification between June 2023 and July 2025. Procedures were performed via median sternotomy or endoscopic mini-thoracotomy. Ultrasonic aspiration was used to remove and sculpt MAC, enabling annular remodelling and secure repair. The primary outcome was repair success and residual regurgitation; secondary outcomes included mortality and perioperative complications. Results: Mitral repair was successfully performed in 26 patients (96.3%), with one conversion to replacement. There were no in-hospital deaths, strokes, atrioventricular (AV) groove disruptions, or reoperations. At discharge, 96.3% had none or mild residual MR; one patient (3.7%) had moderate MR. Mean coaptation length was 10.3±3.2 mm. Postoperative complications included new-onset atrial fibrillation in five patients (18.5%) and permanent pacemaker implantation in two (7.4%). Sternotomy approach was used in 63% and endoscopic mini-thoracotomy in 37%. Mean cardiopulmonary bypass (CPB) and cross-clamp times were 159.6±46.8 and 116.9±46.5 min, respectively. Most mitral repairs addressed isolated posterior leaflet prolapse (66.7%) or bileaflet prolapse (22.2%). Primary repair strategies included leaflet resection (51.9%), isolated neochords (25.9%), or resection with neochords (22.2%). MAC decalcification was primarily performed in the posterior annulus. Conclusions: Ultrasonic emulsification is a safe, effective adjunct for mitral valve repair in moderate-to-severe MAC, enabling precise decalcification and high repair rates with minimal complications. This approach may expand repair candidacy and merits further comparative studies with long-term follow-up.

Indexed as

Mitral annular calcification (MAC)mitral valve repairultrasonic emulsification

Identifiers

PMID41383191
PMCPMC12690416

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.