Background: Aortic valve (AV) replacement is the gold standard treatment for severe symptomatic AV disease. Recently, AV reconstruction surgery (Ozaki procedure) emerges as a surgical alternative with good results in the medium term. Methods: We retrospectively analyzed 37 patients who underwent AV reconstruction surgery between January 2018 and June 2020 in a national reference center in Lima, Peru. The median age was 62 years, interquartile range . The main indication for surgery was AV stenosis (62.2%), in most cases due to bicuspid valve (19 patients, 51.4%). Twenty-two (59.4%) patients had another pathology with surgical indication associated to AV disease, 8 (21.6%) had dilatation of the ascending aorta with indication for replacement. Results: One in-hospital death occurred (1/38, 2.7%) due to perioperative myocardial infarction. There was a significant reduction in the medians of the peak (70 mmHg,

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Background Aortic valve replacement is the gold standard treatment for severe symptomatic aortic valve disease. Recently, aortic valve reconstruction surgery (Ozaki procedure) emerges as a surgical alternative with good results in the medium term. Methods We retrospectively analyzed 38 patients who underwent aortic valve reconstruction surgery between January 2018 and June 2020 in a national reference center in Lima, Peru. The median age was 62 years, interquartile range 25. The main indication for surgery was aortic valve stenosis (63.1%), in most cases due to bicuspid valve (19 patients, 50%). Twenty-two (58%) patients had another pathology with surgical indication associated to AV disease, 8(21%) had dilatation of the ascending aorta with indication for replacement. Results One in-hospital death occurred (1/38, 2.6%) due to perioperative myocardial infarction. There was a significant reduction in the medians of the peak (66mmHg, CI95%=52.5-81.3 vs 15mmHg, CI95%=12.1-17.5, p<0.0001) and mean (41mmHg CI95%=31.8-50.1 vs 8mmHg, CI95%=6.0-9.6, p<0.0001) aortic valve gradients when we compared baseline characteristics with first 30-days results. In an average of 19 (±8.9) months of follow-up, survival, reoperation-free survival for valve dysfunction, and survival free of AV insufficiency> II were 94.6%, 94.6% y 91.7%, respectively. Significant reduction in the medians of the peak (66mmHg, CI95%=52.5-81.3 vs 14mmHg, CI95%=10.9-17.6, p<0.0001) and mean (41mmHg CI95%=31.8-50.1 vs 7mmHg, CI95%=5.2-9.1, p<0.0001) aortic valve gradients were maintained. Conclusions Mid-term outcome follow-up of aortic valve reconstruction surgery showed optimal results in term of mortality, reoperation free survival and hemodynamic characteristics of the neo-aortic valve.