Pregnancy after Ozaki aortic valve reconstruction in a woman with bicuspid aortic valve: a case report

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  Clinical course of pregnancy following the Ozaki procedure. Schematic timeline illustrating the clinical course of a woman with congenital aortic valve disease who underwent the Ozaki procedure and subsequently completed a successful pregnancy. The patient underwent balloon aortic valvuloplasty at 5 years of age, developed severe aortic stenosis by 19 years, and underwent Ozaki aortic valve reconstruction at 20 years of age. One-year postoperative follow-up demonstrated normalization of left ventricular dimensions and improvement in the left ventricular outflow tract (LVOT) gradient. Pregnancy at 22 years of age was managed by a multidisciplinary cardio-obstetric team, with stable transvalvular gradients (39/18 mmHg) documented at both 13 and 26 weeks of gestation. The pregnancy progressed uneventfully, culminating in the vaginal delivery of a healthy infant at 39 + 5 weeks. At 18 months postpartum, valve function remained stable without structural deterioration. This case highlights the excellent haemodynamic durability of the Ozaki procedure during the physiological stress of pregnancy and supports its potential advantages in young women of childbearing age, including…

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  Figure 1. Representative intraoperative photographs demonstrating the key steps of the Ozaki procedure. Representative intraoperative images demonstrating the principal steps of the Ozaki procedure using glutaraldehyde-treated autologous pericardium for aortic valve reconstruction. (A) Preparation of the autologous pericardial patch using the Ozaki template system. The pericardium is marked according to the measured leaflet size to create a patient-specific neocusp. The asterisk indicates the reference point for template alignment, and the arrow denotes the orientation mark. (B) Harvested autologous pericardium after exposure and before excision, with stay sutures providing optimal visualization and handling. The asterisk indicates the underlying cardiac structures. (C) Glutaraldehyde-treated autologous pericardium secured to the Ozaki sizing board, allowing precise leaflet trimming according to the selected template. The arrow indicates the treated pericardial edge. (D) Final intraoperative view of the completed aortic valve neocuspidization, demonstrating three newly constructed autologous pericardial leaflets with excellent symmetry and central coaptation, resulting in a competent…