Early and Mid-term Results of Aortic Valve Reconstruction with Autologous Pericardium (Ozaki Procedure): A Multicenter Study in Japan Outside of Toho University

Abstract

Objective: Aortic valve reconstruction (AVrec) using autologous pericardium, which was devised by Prof. Ozaki of Toho University, has already shown good early and 10-year results by Prof. Ozaki. We verify whether this technique can be a general procedure by giving early and mid-term results outside of Toho University in Japan. Methods: Patients who had AVrec with the autologous or xenologous pericardium during a period from Apr/2010 to March/ 2018 were enrolled (n=577) in 16 institutions excluding Toho University in Japan. The follow-up data, including echocardiography, has been collected for a maximum of 8 years. Data were collected via the Internet using the REDCapTM data integration management system.Mean age was 72±13 (6-13). AV pathologies were AS 312 (54%), AR 138 (23%), ASR 127 (22%) and infective endocarditis 36 (6.2%). In 568 (98%) patients autologous pericardium was used. Isolated AVrec existed in 346 (60%) of the cases. Results: 2 patients were converted to valve replacement. There were 32 (5.5%) hospital deaths in all and 13 (3.8%) in isolated AVrec. Survival rate was 85% @3yrs, 80% @5yrs and 76% @7yrs. Reoperation Free rate was 97% @3yrs, 95% @5yrs and 90% @7yrs. Mean aortic valve pressure gradient was 9.5mmHg @3yrs,10.2mmHg @5yrs and 9.13mmHg @7yrs . AR >moderate was observed in 16% @3yrs, 16% @5yrs and 17% @7yrs of patients. Conclusions: The early and mid-term results of AVrec performed outside of Toho University were generally satisfactory, but the results were poorer than the results reported from Toho University. It is possible these results were affected by including the middle part of the rise of the learning curve.