[II-IPD-05] Congenital Aortic and Truncal Valve Reconstruction Utilizing the Ozaki Technique : Mid–term Clinical Results
Objectives: Aortic valve reconstruction (AVRec) with neo-cuspidization or the Ozaki procedure with complete cusp replacement for aortic valve disease has excellent mid-term results in adults. Limited results of AVRec in pediatric patients have been reported. We report our mid-term outcomes of the Ozaki procedure for congenital aortic and truncal valve disease.
Methods: Retrospective analysis was performed on all xx patients with congenital aortic and truncal valve disease that had a three leaflet Ozaki procedure at a single institution from 8/2015 to 2/2021. Outcome measures included mortality, surgical or catheter-based re-interventions and echocardiographic measurements.
Results: xx patients had aortic regurgitation (AR), x had aortic stenosis (AS) and xx patients had AS/AR. Two patients had quadricuspid valves, xx had tricuspid, xx had bicuspid and x had unicusp aortic valves. x patients had truncus arteriosus. xx patients had prior aortic valve repairs and x had replacements. Pre-operative echocardiography mean annular diameter was xx.xx±x.xx cm and peak gradient for AS/AR patients was xx.xx±xx.xx mmHg. Autologous, Photofix® and CardioCel® bovine pericardium were used in xx, xx and x patients. x patients required aortic root enlargement and xx had sinus enlargement. xx patients had concomitant procedures. Median ICU and hospital LOS were x.xx and x.xx days. There were no hospital mortalities or early conversions to valve replacement. At discharge, xx% of patients had mild or less regurgitation and peak aortic gradient was xx.x±x.x mmHg. xx patients underwent aortic valve replacement. At median follow-up of x.x months, xx% and xx% of patients had less than moderate regurgitation and stenosis, respectively.
Conclusions: The AVRec procedure has acceptable short-term results in all patinets but poor mid-term results in patients where Photofix® pericardium was used. AVRec could be considered for valve reconstruction in pediatric patients with congenital aortic and truncal valve disease if native autologous pericardium is available. Longer-term follow-up is necessary to determine the optimal patch material and late valve function and continued annular growth.
Methods: Retrospective analysis was performed on all xx patients with congenital aortic and truncal valve disease that had a three leaflet Ozaki procedure at a single institution from 8/2015 to 2/2021. Outcome measures included mortality, surgical or catheter-based re-interventions and echocardiographic measurements.
Results: xx patients had aortic regurgitation (AR), x had aortic stenosis (AS) and xx patients had AS/AR. Two patients had quadricuspid valves, xx had tricuspid, xx had bicuspid and x had unicusp aortic valves. x patients had truncus arteriosus. xx patients had prior aortic valve repairs and x had replacements. Pre-operative echocardiography mean annular diameter was xx.xx±x.xx cm and peak gradient for AS/AR patients was xx.xx±xx.xx mmHg. Autologous, Photofix® and CardioCel® bovine pericardium were used in xx, xx and x patients. x patients required aortic root enlargement and xx had sinus enlargement. xx patients had concomitant procedures. Median ICU and hospital LOS were x.xx and x.xx days. There were no hospital mortalities or early conversions to valve replacement. At discharge, xx% of patients had mild or less regurgitation and peak aortic gradient was xx.x±x.x mmHg. xx patients underwent aortic valve replacement. At median follow-up of x.x months, xx% and xx% of patients had less than moderate regurgitation and stenosis, respectively.
Conclusions: The AVRec procedure has acceptable short-term results in all patinets but poor mid-term results in patients where Photofix® pericardium was used. AVRec could be considered for valve reconstruction in pediatric patients with congenital aortic and truncal valve disease if native autologous pericardium is available. Longer-term follow-up is necessary to determine the optimal patch material and late valve function and continued annular growth.