Key result
Aortic valve reconstruction surgery reduced median peak aortic valve gradients from 66 mmHg at baseline to 15 mmHg at 30 days, with 94.6% survival at 19 months.
Why the study?
Aortic valve replacement is the standard treatment for severe symptomatic aortic valve disease, but aortic valve reconstruction surgery (Ozaki procedure) has emerged as an alternative with good medium-term results.
Does aortic valve reconstruction surgery (Ozaki procedure) improve hemodynamics and clinical outcomes in patients with severe symptomatic aortic valve disease?
Cohort (n=38)
No
Does aortic valve reconstruction surgery (Ozaki procedure) improve hemodynamics and clinical outcomes in patients with severe symptomatic aortic valve disease?
Answers are grounded in this paper and cite their sources.
Aortic valve reconstruction surgery (Ozaki procedure) demonstrates excellent mid-term survival, freedom from reoperation, and significant hemodynamic improvements in a Peruvian cohort.
Background Aortic valve replacement is the gold standard treatment for severe symptomatic aortic valve disease. Recently, aortic valve reconstruction surgery (Ozaki procedure) emerges as a surgical alternative with good results in the medium term. Methods We retrospectively analyzed 38 patients who underwent aortic valve reconstruction surgery between January 2018 and June 2020 in a national reference center in Lima, Peru. The median age was 62 years, interquartile range 25. The main indication for surgery was aortic valve stenosis (63.1%), in most cases due to bicuspid valve (19 patients, 50%). Twenty-two (58%) patients had another pathology with surgical indication associated to AV disease, 8(21%) had dilatation of the ascending aorta with indication for replacement. Results One in-hospital death occurred (1/38, 2.6%) due to perioperative myocardial infarction. There was a significant reduction in the medians of the peak (66mmHg, CI95%=52.5-81.3 vs 15mmHg, CI95%=12.1-17.5, p<0.0001) and mean (41mmHg CI95%=31.8-50.1 vs 8mmHg, CI95%=6.0-9.6, p<0.0001) aortic valve gradients when we compared baseline characteristics with first 30-days results. In an average of 19 (±8.9) months of follow-up, survival, reoperation-free survival for valve dysfunction, and survival free of AV insufficiency> II were 94.6%, 94.6% y 91.7%, respectively. Significant reduction in the medians of the peak (66mmHg, CI95%=52.5-81.3 vs 14mmHg, CI95%=10.9-17.6, p<0.0001) and mean (41mmHg CI95%=31.8-50.1 vs 7mmHg, CI95%=5.2-9.1, p<0.0001) aortic valve gradients were maintained. Conclusions Mid-term outcome follow-up of aortic valve reconstruction surgery showed optimal results in term of mortality, reoperation free survival and hemodynamic characteristics of the neo-aortic valve.
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Ríos‐Ortega et al. (2022) conducted a cohort in Severe symptomatic aortic valve disease (n=38). Aortic valve reconstruction surgery (Ozaki procedure) vs. Baseline was evaluated on Peak aortic valve gradient at 30 days (p=<0.0001). Aortic valve reconstruction surgery reduced median peak aortic valve gradients from 66 mmHg at baseline to 15 mmHg at 30 days, with 94.6% survival at 19 months.
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