Preliminary experience of Ozaki procedure for adult aortic valve disease in a single center_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LU Qilin ¹ , LIU Shiqiang ¹ , XU Kanglin ¹ , ZHU Guiying ¹ , LI Peidong ¹ , LIU Junning ¹ , LU Ziao ¹ , LEI Yong ¹ , WANG Yongjie ¹ ,  ZHANG Haibo ^1,2

1. Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital Medical University Nanchong Branch, Nanchong Central Hospital, Nanchong, 637000, Sichuan, P. R. China;
2. Department of Cardiovascular surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing, 100020, P. R. China;

Corresponding author：

ZHANG Haibo, Email: Zhanghb2318@163.com

Keywords：

Ozaki procedure; surgical treatment; aortic valve disease; adult

DOI：

10.7507/1007-4848.202508050

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the short-term efficacy and safety of Ozaki surgery in treating adult patients with aortic valve disease and to summarize clinical experience. Methods Clinical data of adult patients with aortic valve disease who underwent Ozaki surgery in the Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital Medical University Nanchong Branch in 2025 were collected, and the effectiveness and safety of Ozaki surgery were analyzed. Results A total of 5 patients were included, including 3 males and 2 females, with an average age of (47.80±12.99) years. One patient was aortic stenosis, 2 patients were aortic regurgitation, and 2 patients were aortic stenosis combined with regurgitation. Two patients underwent isolated Ozaki surgery, 1 patient underwent Ozaki+coronary artery bypass surgery, and 2 cases underwent Ozaki+mitral valve plasty+tricuspid valve plasty. The average operation time was (6.70±1.25) hours. The average extracorporeal circulation time was (217.20±59.47) minutes, the average aortic cross-clamping time was (153.60±45.71) minutes, the average postoperative ventilator support time was (25.00±11.79) hours, the average intensive care unit stay was (2.43±1.30) days, and the average postoperative hospital stay was (11.20±1.92) days. The postoperative average aortic valve flow rate was (1.70±0.26) m/s, and the average transvalve pressure gradient was (11.00±1.87) mm Hg. Postoperatively, 3 patients had no aortic regurgitation, and 2 patients had trace regurgitation. Postoperative complications included pulmonary infection in 3 patients, severe pneumonia in 1 patient, liver function damage in 4 patients, and renal function damage in 3 patients. No patients experienced arrhythmias or other complications. All 5 patients recovered and were discharged, and their cardiac function significantly improved postoperatively compared to preoperatively (P<0.001), with both left ventricle (P=0.047) and left atrium (P=0.016) reduced in size. Conclusion The short-term results of Ozaki surgery for adult patients with aortic valve disease are satisfied, but long-term outcomes still need further exploration.

1.	Peters AS, Duggan JP, Trachiotis GD, et al. Epidemiology of valvular heart disease. Surg Clin North Am, 2022, 102(3): 517-528.
2.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
3.	Kulik A, Bédard P, Lam BK, et al. Mechanical versus bioprosthetic valve replacement in middle-aged patients. Eur J Cardiothorac Surg, 2006, 30(3): 485-491.
4.	Montero JA, Venturino F, Cubas S, et al. Comparative evaluation of mechanical and biological prostheses in patients with aortic stenosis. Interdiscip Cardiovasc Thorac Surg, 2025, 40(5): ivaf091.
5.	Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact Cardiovasc Thorac Surg, 2011, 12(4): 550-553.
6.	Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. J Thorac Cardiovasc Surg, 2018, 155(6): 2379-2387.
7.	Krane M, Boehm J, Prinzing A, et al. Excellent hemodynamic performance after aortic valve neocuspidization using autologous pericardium. Ann Thorac Surg, 2021, 111(1): 126-133.
8.	Koechlin L, Schurr U, Miazza J, et al. Echocardiographic and clinical follow-up after aortic valve neocuspidization using autologous pericardium. World J Surg, 2020, 44(9): 3175-3181.
9.	Yamamoto Y, Iino K, Shintani Y, et al. Comparison of aortic annulus dimension after aortic valve neocuspidization with valve replacement and normal valve. Semin Thorac Cardiovasc Surg, 2017, 29(2): 143-149.
10.	Iida Y, Fujii S, Akiyama S, et al. Early and mid-term results of isolated aortic valve neocuspidization in patients with aortic stenosis. Gen Thorac Cardiovasc Surg, 2018, 66(11): 648-652.
11.	Sá MPBO, Chernov I, Marchenko A, et al. Aortic valve neocuspidization (Ozaki procedure) in patients with small aortic annulus (≤21 mm): a multicenter study. Struct Heart, 2020, 4(5): 413-419.
12.	Halder V, Mishra A, Ghosh S, et al. Effectiveness and safety of the Ozaki procedure for aortic valve disease in pediatric patients: a systematic review and meta-analysis. Cureus, 2023, 15(9): e45269.
13.	魏志潘, 张岩伟, 郑家永, 等. Ozaki手术治疗儿童主动脉瓣疾病效果观察. 中华实用诊断与治疗杂志, 2025, 39(2): 112-116.Wei ZP, Zhang YW, Zheng JY, et al. Observation on the effect of Ozaki procedure in the treatment of aortic valve diseases in children. Chin J Pract Diagn Ther, 2025, 39(2): 112-116.
14.	张思宇, 芮璐, 马凯, 等. Ozaki手术行小儿主动脉瓣成形近中期效果的单中心研究. 中国心血管病研究, 2021, 19(7): 640-643.Zhang SY, Rui L, Ma K, et al. Short- and medium-term effects of Ozaki surgery for pediatric aortic valve repair: a single-center study. Chin J Cardiovasc Res, 2021, 19(7): 640-643.
15.	刘鑫荣, 朱宏斌, 董卫, 等. Ozaki手术在小儿主动脉瓣反流中的应用. 中国胸心血管外科临床杂志, 2020, 27(11): 1292-1297.Liu XR, Zhu HB, Dong W, et al. Application of Ozaki procedure in pediatric aortic regurgitation. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(11): 1292-1297.
16.	Pirola S, Mastroiacovo G, Arlati F, et al. Single center 5-years' experience of Ozaki procedure: mid-term follow-up. Ann Thorac Surg, 2021, 111(5): 1692-1698.
17.	Mokryk I, Nechai I, Stetsyuk I, et al. Complete aortic valve reconstruction with autologous pericardium: analysis of mid-term results of single-center experience with AVNeo procedure. Ann Thorac Cardiovasc Surg, 2024, 30(1): 24-33.
18.	Benedetto U, Sinha S, Dimagli A, et al. Aortic valve neocuspidization with autologous pericardium in adult patients: UK experience and meta-analytic comparison with other aortic valve substitutes. Eur J Cardiothorac Surg, 2021, 60(1): 34-46.

1. Peters AS, Duggan JP, Trachiotis GD, et al. Epidemiology of valvular heart disease. Surg Clin North Am, 2022, 102(3): 517-528.
2. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
3. Kulik A, Bédard P, Lam BK, et al. Mechanical versus bioprosthetic valve replacement in middle-aged patients. Eur J Cardiothorac Surg, 2006, 30(3): 485-491.
4. Montero JA, Venturino F, Cubas S, et al. Comparative evaluation of mechanical and biological prostheses in patients with aortic stenosis. Interdiscip Cardiovasc Thorac Surg, 2025, 40(5): ivaf091.
5. Ozaki S, Kawase I, Yamashita H, et al. Aortic valve reconstruction using self-developed aortic valve plasty system in aortic valve disease. Interact Cardiovasc Thorac Surg, 2011, 12(4): 550-553.
6. Ozaki S, Kawase I, Yamashita H, et al. Midterm outcomes after aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium. J Thorac Cardiovasc Surg, 2018, 155(6): 2379-2387.
7. Krane M, Boehm J, Prinzing A, et al. Excellent hemodynamic performance after aortic valve neocuspidization using autologous pericardium. Ann Thorac Surg, 2021, 111(1): 126-133.
8. Koechlin L, Schurr U, Miazza J, et al. Echocardiographic and clinical follow-up after aortic valve neocuspidization using autologous pericardium. World J Surg, 2020, 44(9): 3175-3181.
9. Yamamoto Y, Iino K, Shintani Y, et al. Comparison of aortic annulus dimension after aortic valve neocuspidization with valve replacement and normal valve. Semin Thorac Cardiovasc Surg, 2017, 29(2): 143-149.
10. Iida Y, Fujii S, Akiyama S, et al. Early and mid-term results of isolated aortic valve neocuspidization in patients with aortic stenosis. Gen Thorac Cardiovasc Surg, 2018, 66(11): 648-652.
11. Sá MPBO, Chernov I, Marchenko A, et al. Aortic valve neocuspidization (Ozaki procedure) in patients with small aortic annulus (≤21 mm): a multicenter study. Struct Heart, 2020, 4(5): 413-419.
12. Halder V, Mishra A, Ghosh S, et al. Effectiveness and safety of the Ozaki procedure for aortic valve disease in pediatric patients: a systematic review and meta-analysis. Cureus, 2023, 15(9): e45269.
13. 魏志潘, 张岩伟, 郑家永, 等. Ozaki手术治疗儿童主动脉瓣疾病效果观察. 中华实用诊断与治疗杂志, 2025, 39(2): 112-116.Wei ZP, Zhang YW, Zheng JY, et al. Observation on the effect of Ozaki procedure in the treatment of aortic valve diseases in children. Chin J Pract Diagn Ther, 2025, 39(2): 112-116.
14. 张思宇, 芮璐, 马凯, 等. Ozaki手术行小儿主动脉瓣成形近中期效果的单中心研究. 中国心血管病研究, 2021, 19(7): 640-643.Zhang SY, Rui L, Ma K, et al. Short- and medium-term effects of Ozaki surgery for pediatric aortic valve repair: a single-center study. Chin J Cardiovasc Res, 2021, 19(7): 640-643.
15. 刘鑫荣, 朱宏斌, 董卫, 等. Ozaki手术在小儿主动脉瓣反流中的应用. 中国胸心血管外科临床杂志, 2020, 27(11): 1292-1297.Liu XR, Zhu HB, Dong W, et al. Application of Ozaki procedure in pediatric aortic regurgitation. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(11): 1292-1297.
16. Pirola S, Mastroiacovo G, Arlati F, et al. Single center 5-years' experience of Ozaki procedure: mid-term follow-up. Ann Thorac Surg, 2021, 111(5): 1692-1698.
17. Mokryk I, Nechai I, Stetsyuk I, et al. Complete aortic valve reconstruction with autologous pericardium: analysis of mid-term results of single-center experience with AVNeo procedure. Ann Thorac Cardiovasc Surg, 2024, 30(1): 24-33.
18. Benedetto U, Sinha S, Dimagli A, et al. Aortic valve neocuspidization with autologous pericardium in adult patients: UK experience and meta-analytic comparison with other aortic valve substitutes. Eur J Cardiothorac Surg, 2021, 60(1): 34-46.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Latest ArticlesPreliminary experience of Ozaki procedure for adult aortic valve disease in a single center

Abstract Full text Figures/Tables Video References Cited by

Format

Content