Key result
The Ozaki procedure restored a physiological laminar flow pattern without bi-valvular disease and resulted in significantly fewer adverse effects and shorter hospital stays compared to the Ross procedure.
Why the study?
Surgical options for pediatric aortic valve disease are limited, and while the Ross procedure carries risks like neo-aortic dilatation and future re-interventions, comparative evidence on the Ozaki procedure in children is needed.
Does the Ozaki procedure improve physiological laminar flow pattern and hemodynamic parameters compared to the Ross procedure in pediatric patients with aortic valve disease?
Meta-Analysis (n=251)
Does the Ozaki procedure improve physiological laminar flow pattern and hemodynamic parameters compared to the Ross procedure in pediatric patients with aortic valve disease?
The Ozaki procedure appears to be a safe and effective alternative to the Ross procedure for pediatric aortic valve disease, associated with shorter hospital stays, fewer adverse effects, and fewer re-interventions.
Answers are grounded in this paper and cite their sources.
Ozaki may serve as a single-valve option in children; leaves open need for prospective trials versus Ross.
The surgical treatment options for pediatric aortic valve disease are limited and have debatable long-term durability. In the current situation, the Ross procedure is considered in children for aortic valve disease(s). It is a complex surgical procedure with the risk of neo-aortic dilatation, converting a single valve disease into double valve disease, and associated with future re-interventions. Conversely, the Ozaki procedure has shown promising results in adults. Thus, the present study aimed to provide comparative evidence on the effectiveness and safety of the Ozaki versus Ross procedure for pediatric patients by performing a meta-analytic comparison of reporting outcomes. A total of 15 relevant articles were downloaded and among them, seven articles (one prospective study, five retrospective studies, and one case series) were used in the analysis. Primary outcomes such as physiological laminar flow pattern and hemodynamic parameters, and secondary outcomes such as hospital stays, adverse effects, mortality, and numbers of re-intervention(s) were measured in the meta-analysis. There were no significant differences in the age of patients between children who underwent the Ozaki procedure and those who underwent the Ross procedure at the time of surgeries. The Ozaki procedure is a good solution to an aortic problem(s) similar to the Ross procedure. Unlike the Ross procedure, the Ozaki procedure has restored a physiological laminar flow pattern in the short-term follow-up without the bi-valvular disease. Mean hospital stays (p = 0.048), mean follow-up (p = 0.02), adverse effects (p = 0.02), death, and numbers of re-intervention(s) of children who underwent the Ozaki procedure were fewer than those who underwent the Ross procedure. The time required for re-intervention(s) is higher for children who underwent the Ozaki procedure than those who underwent the Ross procedure. None of the procedures, including the Ozaki procedure for aortic valve disease(s), has significant effects on hemodynamic parameters and the frequent death rate of children after surgeries. Based on our analysis, we may suggest the Ozaki procedure for aortic valve disease surgery in children.
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Halder et al. (2023) conducted a meta-analysis in Aortic valve disease (n=251). Ozaki procedure vs. Ross procedure was evaluated on Physiological laminar flow pattern and hemodynamic parameters. The Ozaki procedure restored a physiological laminar flow pattern without bi-valvular disease and resulted in significantly fewer adverse effects and shorter hospital stays compared to the Ross procedure.
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