Ahmadov Kamran, Kazimzade Nigar, Musayev Kamran
Department of Cardiovascular Surgery, Merkezi Klinika, Bakı, Azerbaijan.
Turk Gogus Kalp Damar Cerrahisi Derg. 2024 Dec 31;32(4 Suppl 2):045-45. doi: 10.5606/tgkdc.dergisi.2024.msb-25. eCollection 2024 Nov.
This study aimed to report the outcomes of the Ozaki procedure, which involves reconstructing aortic valve leaflets with autologous pericardium, performed in a clinic in Azerbaijan.
This retrospective study analyzed 40 patients who underwent aortic valve reconstruction between August 2018 and June 2023. Patients were divided into two groups: Group A (mean age: 63 years) followed the traditional Ozaki technique, while Group B (mean age: 65 years) received an additional commissural reinforcement, a modification proposed by our team.
Presenting symptoms were aortic stenosis or a combination of aortic stenosis and aortic regurgitation. Preoperative echocardiography showed peak and mean pressure gradients of 84±34.6 and 50.5±23 mmHg, respectively. Cardiopulmonary bypass and aortic cross-clamp times averaged 142 and 115 min for Group A and 144 and 107 min for Group B. There were no in-hospital mortalities or pacemaker implantations. No significant increases in aortic gradients were noted, and no reoperations were required. Four patients in Group A developed mild aortic regurgitation during follow-up, while in Group B, aortic regurgitation remained minimal or absent. The median follow-up periods were 64 months for Group A and 28 months for Group B. The study demonstrated 100% freedom from major adverse valve-related events during the follow-up.
Since its introduction, aortic valve neocuspidization has gained popularity. Mid-term results from the Ozaki procedure showed favorable outcomes in terms of mortality, valve gradients, and freedom from adverse valve-related events. While some studies have reported a slight increase in valve regurgitation following the Ozaki procedure, our novel additional commissural reinforcement technique provided a reduction in aortic valve regurgitation during follow-up. Further studies are needed to assess long-term results.
本研究旨在报告在阿塞拜疆一家诊所进行的尾崎手术的结果，该手术采用自体心包重建主动脉瓣叶。
这项回顾性研究分析了2018年8月至2023年6月期间接受主动脉瓣重建的40例患者。患者分为两组：A组（平均年龄：63岁）采用传统的尾崎技术，而B组（平均年龄：65岁）接受了我们团队提出的改良术式，即额外进行瓣叶交界加固。
主要症状为主动脉瓣狭窄或主动脉瓣狭窄合并主动脉瓣关闭不全。术前超声心动图显示峰值和平均压力阶差分别为84±34.6 mmHg和50.5±23 mmHg。A组体外循环和主动脉阻断时间平均分别为142分钟和115分钟，B组分别为144分钟和107分钟。住院期间无死亡病例，也未进行起搏器植入。主动脉压力阶差无显著增加，无需再次手术。A组有4例患者在随访期间出现轻度主动脉瓣关闭不全，而B组主动脉瓣关闭不全仍为轻度或未出现。A组和B组的中位随访时间分别为64个月和28个月。研究表明，随访期间主要瓣膜相关不良事件的发生率为0%。
自引入以来，主动脉瓣新瓣叶化手术越来越受欢迎。尾崎手术的中期结果在死亡率、瓣膜压力阶差和瓣膜相关不良事件发生率方面显示出良好的效果。虽然一些研究报告称尾崎手术后瓣膜反流略有增加，但我们新的瓣叶交界加固技术在随访期间减少了主动脉瓣反流。需要进一步研究来评估长期结果。
