The role of modifi cation of the original ozaki technique in the treatment of aortic valve diseases

Abstract

The aim of this pilot study is to present our one-year experience with the modifi cation of the original Ozaki procedure for patients with an aortic valve stenosis and aortic valve infective endocarditis. Thirteen patients at the age of 70.5 } 10 (women/men: 8/5) underwent a replacement of the aortic valve using autologous or heterologous equinus pericardium. The indication for surgery was aortic valve stenosis (n = 10) or aortic valve regurgitation due to infective endocarditis (n = 3). Concomitant MAZE procedure (n = 2), aortocoronary bypass (n = 1), and left ventricular outfl ow tract myectomy (n = 1) were performed in four patients. One patient refused blood transfusion for religious reasons. The duration of cardiopulmonary bypass was 117.5 } 14.5 minutes and the X-clamp time was 107.0 } 14.4 minutes. The mean gradient after surgery was 5.1 } 1.9 mmHg; the peak gradient was 5.8 } 2.0 mmHg; the aortic valve area was 3.3 } 0.5 cm2 and aortic valve regurgitation was 0.3 } 0.2. No 30-day mortality and no redo surgery due to valve failure were recorded. One patient died three months after surgery due to non- -valve-related reasons. The modifi ed Ozaki technique is a potentially effective alternative for younger patients rejecting anticoagulant medications and requiring aortic valve surgery. The preferred target group of patients for the use of this technique are those with a small aortic annulus and those with active infectious endocarditis.