Midterm outcomes of the Ozaki procedure in patients with a bicuspid aortic valve: retrospective single-center, non-randomized, parallel-group study

Abstract

BACKGROUND: An alternative to plastic surgery on the bicuspid aortic valve (BAV) can be replacement of the leaflets with autopericardium using the Ozaki technique. The procedure is characterized by excellent hemodynamic results in the short and long term in patients with tricuspid aortic valve (TAV). However, the question remains about the long-term results of the procedure and the frequency of reoperations in patients with BAV. OBJECTIVE: To analyze the midterm outcomes of the Ozaki procedure in patients with BAV. MATERIALS AND METHODS: Retrospective single-center, non-randomized, parallel-group study was conducted. Since January 2015 to October 1, 2023, the clinic performed 809 Ozaki procedures. The work included 540 patients with studied midterm and long-term outcomes for up to 5 years. Both isolated aortic valve replacement and combined operations with coronary artery bypass grafting and (or) correction of mitral and tricuspid valve defects were performed. RESULTS: Midterm mortality was 5.7% (n=3) in the group with BAV and 7.3% (n=36) in the group with TAV. Reoperation for aortic regurgitation was required in 16 patients (2.9%): 1 patient (1.9%) in BAV group and 15 (3.3%) in TAV group. Freedom from reoperations in patients with BAV after the Ozaki procedure for up to 5 years was 95.4%, in the group with TAV — 92.6%. The peak gradient on the aortic valve in the group with BAV was 16±7.3, in TAV group— 16.4±10.9. 5 years after surgery, the mean gradient on the aortic valve does not exceed 10 mm Hg. CONCLUSION: The Ozaki operation in patients with BAV is an effective and safe procedure in the midterm follow-up period.