Abstrakt
The aim of this pilot study is to present our one-year experience with the modification of the original Ozaki procedure for patients with an aortic valve stenosis and aortic valve infective endocarditis. Thirteen patients at the age of 70.5 +/- 10 (women/men: 8/5) underwent a replacement of the aortic valve using autologous or heterologous equinus pericardium.
The indication for surgery was aortic valve stenosis (n = 10) or aortic valve regurgitation due to infective endocarditis (n = 3). Concomitant MAZE procedure (n = 2), aortocoronary bypass (n = 1), and left ventricular outflow tract myectomy (n = 1) were performed in four patients.
One patient refused blood transfusion for religious reasons. The duration of cardiopulmonary bypass was 117.5 +/- 14.5 minutes and the X-clamp time was 107.0 +/- 14.4 minutes.
The mean gradient after surgery was 5.1 +/- 1.9 mmHg; the peak gradient was 5.8 +/- 2.0 mmHg; the aortic valve area was 3.3 +/- 0.5 cm(2) and aortic valve regurgitation was 0.3 +/- 0.2. No 30-day mortality and no redo surgery due to valve failure were recorded.
One patient died three months after surgery due to non-valve-related reasons. The modified Ozaki technique is a potentially effective alternative for younger patients rejecting anticoagulant medications and requiring aortic valve surgery.
The preferred target group of patients for the use of this technique are those with a small aortic annulus and those with active infectious endocarditis.