Key result
Aortic neocuspidization with autologous pericardium significantly reduced peak aortic valve pressure from 89.06 mmHg preoperatively to 18.13 mmHg at 6 months.
Why the study?
Aortic neocuspidization has been adopted by limited centers despite reported successful mid-long term results, prompting this single-center presentation of initial experience.
Cohort (n=24)
No
Absolute Event Rate: 18.13% vs 89.06%
p-value: p=0.001
The AVNeo (Ozaki) procedure using autologous pericardium demonstrates favorable short-term hemodynamic outcomes and safety for aortic valve pathologies, avoiding the need for long-term anticoagulation.
AVNeo appears feasible in small single-center series; leaves open durability, safety, and generalizability for prospective multicenter evaluation.
Background: Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with the publication of the mid-long term successful results. The aim of this study was to present initial experience of the AVNeo procedure of a single center. Methods: The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. Results: The mean age of patients was aged 58.21 ± 13.14 years and 16 (66.7%) of them were men. 16 patients were operated on for aortic stenosis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bicuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed in 13 (54.17%) patients. No patients needed reoperation for bleeding, pacemaker implantations, conversion to classical prosthetic aortic valve replacement, or infective endocarditis. Two patients died due to non-cardiac reasons. Preoperative peak and mean aortic valve pressures improved significantly at 1st and 6th months (Preop: 89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmHg 1st month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6th month: 18.13 ± 3.02 mmHg and 6.93 ± 1.83 mmHg). Conclusion: In conclusion, the AVNeo procedure is a feasible technique for aortic valve pathologies, with the advantages of avoiding anticoagulants and the applicability of concomitant surgical procedures. Although this procedure requires meticulous experience, results similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.
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Karabacak et al. (2021) conducted a cohort in Aortic valve disease (n=24). Aortic neocuspidization (AVNeo) with autologous pericardium vs. Preoperative baseline was evaluated on Peak aortic valve pressure at 6 months (p=0.001). Aortic neocuspidization with autologous pericardium significantly reduced peak aortic valve pressure from 89.06 mmHg preoperatively to 18.13 mmHg at 6 months.
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