Short-term outcomes of aortic valve neocuspidization for various aortic valve diseases

Abstract

Objectives: Bioprosthetic valve deterioration remains a major limitation following aortic valve replacement. Favorable results have been reported with an autologous pericardium aortic valve neocuspidization.Methods: Seventy patients (31 women and 39 men) (mean age, 62 AE 12 years) with aortic stenosis (n ¼ 52 [74%]) or aortic regurgitation (n ¼ 18 [26%]) underwent the aortic valve neocuspidization procedure. Thirty-four patients (49%) had a tricuspid valve, 35 (50%) had a bicuspid valve, and 1 (1%) had a monocuspid valve. European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons scores were, respectively, 2.2% AE 2% and 2.0% AE 1.8%. Four patients (6%) had active endocarditis and 2 (3%) had endocarditis sequelae. One patient (1%) had fibroelastoma. A combined procedure was performed in 33 patients (46%). Results:The follow-up period was 24 AE 12 months. One patient (1%) died in hospital and 1 patient (1%) underwent conventional valve replacement for significant aortic regurgitation. Postoperative peak and mean pressure gradients were respectively 14 AE 5 and 8 AE 3 mm Hg. Aortic valve area was 2.5 AE 0.6 cm 2 . During follow-up, no patients died. Reintervention occurred in 2 patients (3%). At last follow-up, peak pressure gradient was 13 AE 7 mm Hg, mean pressure gradient was 7 AE 4 mm Hg, and aortic valve area was 2.3 AE 0.7 cm 2 . There was 1 recurrence of moderate aortic stenosis (1%). All patients were in New York Heart Association functional class I (90%) or II (10%). Freedom from major valve-related events was 92.1%, (98.5% for death, 95.2% for reintervention, and 95.2% for endocarditis).

Early Outcomes after Aortic Valve Replacement by Pretreated Autologous Pericardium versus Metalic Prosthetic Aortic Valve Replacement

“…Also, Nguyn et al (6) in 2018 published a study including nine patients who underwent a minimally invasive Ozaki procedure. The authors reported a shorter ventilation time (8.4 hours), a shorter time at the ICU (1.6 days) and a shorter hospitalization time (5.8 days) in comparison with other studies (9) .…”

“…The average age was 54 ± 16.4 years (range, 13.8-78.5). 436 individuals who had AVR were investigated by Khatchatourov et al (9) with a mean age of 62.11 years, they included 70 patients (31 women and 39 men) who had autologus intervention. 18 patients (26%) had AR, 7 patients (10%) had both AS and AR, and 45 patients (64%) had AS.…”

Single center two years’ experience of Ozaki procedure: Early follow-up

“…It is inevitable that the duration of cross-clamping will be longer. [ 12 ] After the operation, serious decreases are provided in aortic valve gradient with values similar to native valve. A meta-analysis in 2023 for 1891 patients that underwent AV-Neo using the Ozaki technique provided that mean peak gradient was 15.7 mm Hg in aortic valve and had only %0.25 aortic valve insufficiency after operation.…”

Commentary: AVneo—Impressive early results; however, long-term durability remains unknown

“…In this issue of JTCVS Open , Khatchatourov and colleagues 1 present an impressive series of 70 patients who underwent aortic valve replacement via reconstruction of a new valve with native or xenograft pericardial tissue. This technique, first described by Ozaki and colleagues in 2011, offers an alternative to conventional valve replacement.…”