Gender comparison of immediate and medium-term results of Ozaki operation: a Propensity Score Matching Analysis

Abstract

Highlights. A retrospective analysis of the patients’ data after Ozaki operation in four Russian Medical Centers was carried out. A comparative gender assessment of the immediate and medium-term results of Ozaki operation was performed.Aim. Gender assessment of Ozaki operation immediate and mid-term results in patients with aortic valve (AV) pathology.Methods. A retrospective multicenter study enrolled 251 patients (135 women, median age 66 (60–70) years old) who underwent Ozaki operation (2017–2020) was carried out in four centers in Russia. After propensity score matching, 92 patients were selected (mean age 65.8±10.8 years old). Two groups were formed in the gender structure: 46 females (average age 67.8±6.3 years old), 46 males (average age 63.8±15.4 years old). The main cause of AV dysfunction was severe aortic stenosis – in 86 (93.5%) cases. Chronic heart failure of III–IV functional class according to NYHA was observed in 26 (28.3%) patients. A bicuspid AV was in 24 cases (26.1%). The primary endpoint was hospital mortality. Postoperative complications and mid-term results (three-year overall survival and freedom from reoperation on AV) were assessed as secondary endpoints; the median follow-up period was 23 (18–33) months.Results. There was no statistically significant difference between the groups in the duration of surgery (275 minutes for females and 285 minutes for males, p = 0.4), cardiopulmonary bypass (98 minutes for females and 115 minutes for males, p = 0.3), aortic clamping (80 minutes for females and 93 minutes for males, p = 0.7). Hospital mortality among the studied patients did not differ: in the female group – 2.2% (1 case) and 0 in the male one, p = 0.9. There were no significant differences in postoperative complications: sepsis (2.2% in women and 0 in men, p = 0.9), superficial wound infection (8.7% in women and 6.5% in men, p = 0.9). Acute kidney injury, stroke, pacemaker implantation, resternotomy for bleeding were not observed in any patient. Three-year overall survival was 91.8% in females and 91.6% in males, p = 0.8; three-year freedom from reoperation – 94.4% for females and 100% for males, p = 0.1.Conclusion. Ozaki operation is equally reproducible with the same hospital mortality, postoperative complications, and medium-term outcomes in both females and males.