The Ozaki procedure has emerged as a valuable option for treating various aortic valve pathologies. This review article delves into the intricacies of this innovative surgical approach by exploring its adaptation to the complex anatomy and physiology of the aortic root. The diverse etiologies of aortic valve diseases, ranging from congenital anomalies to degenerative changes, make treatment selection a complex challenge. Aortic valve replacement has traditionally been the gold standard, but emerging evidence supports valve repair techniques, emphasizing the importance of preserving native tissue. Nevertheless, issues like lifelong anticoagulation with mechanical valves and patient-prosthetic mismatch remain. The Ozaki procedure offers a compelling alternative by utilizing autologous pericardium or a tissue substitute to construct new aortic valve leaflets. This technique, standardized by Dr. Ozaki in 2007, provides a customizable and adaptable solution. The article highlights the anatomy of the aortic root, emphasizing the critical role of the sinus of Valsalva and interleaflet triangles in maintaining proper valve function. The procedure's unique adaptation to aortic root dynamics allows for reduced mechanical stress during systole and diastole, mimicking the natural valve's behavior. Furthermore, Ozaki leaflets exhibit promising hemodynamics and reduced risks of complications, such as permanent pacemaker implantation and patient-prosthetic mismatch. The use of autologous pericardium in the Ozaki procedure presents advantages, including enhanced tissue strength, minimal immunogenicity, and reduced risk of immune-mediated calcification. These factors contribute to the longevity and resilience of the reconstructed valve. This comprehensive review aims to shed light on the procedure's intricacies, its alignment with aortic root anatomy and physiology, and its potential as a valuable tool in the armamentarium of aortic surgeons.
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http://dx.doi.org/10.1007/s12055-023-01635-z | DOI Listing |
Circ Cardiovasc Interv
January 2025
Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, Canada. (A.H., J.J., S.O., K.M., J.A.L., P.B., D.A.W., S.L.S., J.G.W., J.S.).
Background: Transcatheter heart valve (THV) underexpansion after transcatheter aortic valve replacement may be associated with worse outcomes. THV expansion can be assessed fluoroscopically using a pigtail for calibration; however, the accuracy of this technique specific to transcatheter aortic valve replacement is unknown. We assessed the accuracy and reproducibility of a novel fluoroscopic method to assess THV expansion using the THV commissural post for calibration.
View Article and Find Full Text PDFInt J Cardiol Heart Vasc
February 2025
Department of Medicine, Lady Davis Carmel Medical Center, Haifa, Israel.
Background: Aortic stenosis (AS) is treated through transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), with diabetes being prevalent among these patients. Inflammation participates in the pathogenesis of AS, and emerging evidence suggests that TAVI may exert anti-inflammatory effects. Given the established link between diabetes and inflammation, we sought to evaluate the impact of aortic valve replacement (AVR) on glycemic control.
View Article and Find Full Text PDFMonaldi Arch Chest Dis
January 2025
Cardiology Department, Local Health Unit of Alto Ave, Guimarães.
Multivalvular endocarditis (MVE) is an uncommon presentation and mostly involves mitral and aortic valves. Here, we present a case of an MVE with an unusual and bizarre presentation on a Halloween night with a massive degree of valve destruction and right- and left-side involvement requiring emergent surgery. A 51-year-old male patient with intravenous drug usage presented with anorexia, fever, and dyspnea, rapidly progressing to septic shock with multiorgan dysfunction.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Cardiovascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79#, Qingchun Road, Hangzhou, 310003, China.
Background: Dextrocardia is a rare cardiac malposition where the heart's normal orientation is reversed and is most commonly associated with situs inversus totalis (SIT). Such cases are technically challenging when heart surgery is needed, especially re-do surgery.
Case Presentation: A 72-year-old female patient was referred to our hospital with complaints of chest tightness and reduced activity tolerance.
J Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA.
Mitral and aortic annular calcification is an age-related degenerative process that can result in severe mitral and/or aortic stenosis and/or regurgitation. Annular calcification not only increases the surgical complexity but also increases the risk of complications. In this case report, we present the innovative use of the Sonopet ultrasonic surgical aspirator for aortic and mitral annular decalcification in a patient with hypertrophic obstructive cardiomyopathy, mild aortic stenosis and moderate mitral regurgitation in the presence of mitral annular calcification (MAC) and aorto-mitral curtain calcification.
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