Aortic valve reconstruction surgery with Ozaki technique: initials results from a single center

Abstract

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,

Ozaki Procedure Plus Aortic Annular Enlargement in an Extremely Narrow Aortic Annulus: A Surgical Challenge

“…3 The effective orifice is larger and the transvalvular gradient is lower than prosthesis; the natural shape of the cardiac structure is little altered, and, moreover, the neovalve has better performance. 3,4,6,7 Wiggins et al described the follow-up of 58 patients who underwent the Ozaki procedure and reconstruction of an aortic leaflet. 8 The average age of the patients was 14.8 years; the velocity changed from 3.4 ± 1.2 m/s to 2.0 ± 0.4 m/s at 14.1 months; the absence of reoperation was >94% at 1 year, >85% at 2 years, and >79% at 3 years; and there were 6 late reinterventions (10%), of which 3 were for endocarditis.…”

“…3 The effective orifice is larger and the transvalvular gradient is lower than prosthesis; the natural shape of the cardiac structure is little altered, and, moreover, the neovalve has better performance. 3,4,6,7…”

“…After a medium sternotomy, a portion of anterior pericardium was harvested and removed. Then, the excised pericardium was treated with a 0.6% glutaraldehyde solution according to the techniques already described by Ozaki et al 2 After placing the patient on extracorporeal circulation with aortoatriocaval cannulation, we started the aortotomy 10 mm above the right Innovations 18 (4) coronary ostium and continued it obliquely in what would correspond to the noncoronary sinus. The 2 existing commissures were respected.…”

“…For AV reconstruction, we used a sizer system designed by surgeons and whose results have been previously published. 4…”

“…On the other hand, it does not require the use of subsequent anticoagulation, ideal in patients of childbearing age. 3,4…”