Reconstruction of aortic valve by autologous pericardium (Ozaki’s procedure): Single center experience in Vietnam

Abstract

Aim We aimed to report the experience of aortic valve reconstruction with autologous pericardium using Ozaki’s procedure in Vietnam. Methods The study included consecutive patients with isolated aortic valve disease who underwent Ozaki’s procedure in our hospital between June 2017 and August 2019. Aortic valve leaflets were reconstructed with autologous pericardium using Ozaki’s procedure. Results Sixty-one patients were included (mean age 55.8 years; 41 were male): 24 with aortic stenosis, 17 with aortic regurgitation, and 20 with both. Of the 61 patients, 16 had a bicuspid aortic valve, and 5 had infective endocarditis. The preoperative peak and mean gradient pressure gradients were 91.7 ± 16.1 mm Hg and 55.3 ± 10.3 mm Hg, respectively. Surgery was performed via a full or partial sternotomy. The procedure was successful in 59 cases. Two patients were converted to prosthetic valve replacement. The aortic crossclamp time was 110.9 ± 20.5 minutes. Intraoperative transesophageal echocardiography showed a mean pressure gradient of 8 ± 2 mm Hg and an aortic valve area of 3.04 ± 0.44 cm2. The mean follow-up period was 18.5 ± 5.7 months. One patient died in hospital due to cardiac tamponade. One patient underwent reoperation due to infective endocarditis 6 months after surgery. Another died at 8 months after surgery due to a mediastinal abscess. The surviving patients had no aortic regurgitation or mild aortic regurgitation at the last follow-up visits. Conclusions Aortic valve reconstruction with autologous pericardium provided good outcomes in our study.

Aortic valve reconstruction surgery. Operative results from a Peruvian Cohort Running tittle: AVrec Surgery

“…Recently Ngo et al in a series of 67 patients in Vietnam, reports a 1.7% hospital mortality and a survival of 65/67(97%) patients at one year of follow-up. [21][22][23] The medium-term survival rate in our series is acceptable and comparable with other published cohorts. We had two cases of mortality, the first due to intraoperative coronary embolism in a 68-year-old patient with severely calcified bicuspid AV, who died of circulatory complications despite performing CABG.…”

“…Similar results have been observed in other series. 10,18,[21][22][23] This excellent hemodynamic performance is the result of preserving the natural motion of the aortic valve annulus and the coordination of the left ventricle, aortic annulus, sinus of Valsalva, and aorta. This is particularly important in patients with a small AV annulus.…”

Aortic Valve Reconstruction Surgery Using Autologous Pericardium: The Experience in Vietnam

“…11 In Vietnam, aortic valve reconstruction surgery has just been implemented recently with early results of feasibility and advantages have been reported. 12,13 Therefore, we conducted this study with 02 objectives: (1) To evaluate the indications of aortic valve reconstruction surgery by Ozaki's procedure at our hospital, (2) To report the mid-term outcomes of this method.…”

Initial results of aortic valve reconstruction using autologous pericardium (Ozaki's procedure)

“…Today, this technique, which has been used in many countries with more than 4000 patients undergoing surgery successfully [15], has many reported advantages including no need anticoagulant, a low pressure gradient, a high effective valvular orifice area, and preservation of aortic root physiology. In Vietnam, prosthetic aortic valve replacement has been continued to use as standard procedure, whereas Ozaki's procedure is still considered as a new technique [16]. In addition, there have not been many reports on this technique, thence we conducted this study for two objectives (a) to describe the clinical and echocardiographic changing features before and after surgery, indications and technical procedures of the Ozaki's procedure, (b) to report early results of aortic valve reconstruction using Ozaki's procedure.…”