Three-year results of aortic valve neocuspidization (Ozaki procedure): a multiple-center retrospective study

Objective. To analyze 3-year outcomes after Ozaki procedure. Material and methods. A retrospective multiple-center study included 251 patients with aortic valve disease between January 2017 and February 2020. Results. The main indication for surgery was severe aortic stenosis in 230 (91.6%) cases, bicuspid aortic valve in 88 (35%) cases, aortic regurgitation (AR) in 21 (8.4%) cases and infective endocarditis (IE) in 12 (4.8%) cases. The sample included 116 (46.2%) men and 135 (53.8%) women (mean age 66 (60—70) years). There were no conversions of the Ozaki procedure to aortic valve replacement with biological or mechanical prostheses. Xenopericardium was used in 7 cases due to redo surgeries. Combined interventions were performed in 103 (42.2%) patients. In-hospital mortality was 1.2%. Two (0.8%) patients underwent redo sternotomy for bleeding. Follow-up was completed in all patients (median period 24 (17—32) months). Three-year survival and freedom from redo surgeries were 90.6% and 94.6%, respectively. Postoperative echocardiography revealed mean pressure gradient 6 mm Hg. AR ≥2 was detected in 13 (8.3%) patients in 22.6±9.9 months after surgery. Baseline IE (p=0.04) and AR ≥2 (p=0.006) at discharge are significant predictors of aortic valve dysfunction after Ozaki surgery. Conclusion. The Ozaki procedure in patients with aortic valve disease has favorable immediate results regarding in-hospital mortality and postoperative morbidity, as well as optimal intermediate results regarding survival, freedom from redo surgeries and hemodynamic parameters. Further monitoring of patients is necessary to assess the long-term results after this procedure.