Standardized Aortic Valve Neocuspidization for Treatment of Aortic Valve Diseases.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
10 2022
Historique:
received: 29 10 2021
revised: 04 03 2022
accepted: 20 03 2022
pubmed: 20 4 2022
medline: 30 9 2022
entrez: 19 4 2022
Statut: ppublish

Résumé

Aortic valve replacement is the traditional surgical treatment for aortic valve diseases, yet standardized aortic valve neocuspidization (AVNeo) is a promising alternative that is gaining popularity. The purpose of this article is to review the available published literature of AVNeo using glutaraldehyde-treated autologous pericardium, also known as the Ozaki procedure, including indications, outcomes, potential benefits, and modes of failure for the reconstructed valve. A comprehensive literature search was performed using keywords related to aortic valve repair, AVNeo, or Ozaki procedure. All articles describing performance of AVNeo were reviewed. Reported early mortality after AVNeo varies from 0% to 5.88%. The largest cohort of patients in the literature includes 850 patients with an inhospital mortality rate of 1.88%. Cumulative incidence of aortic valve reoperation was 4.2% in the largest series. Reoperation was uncommon and mainly due to infective endocarditis or degeneration of the reconstructed valve (most commonly due to aortic valve regurgitation, rather than stenosis). Aortic valve neocuspidization is a versatile and standardized alternative to aortic valve replacement with a biological prosthesis. Early to midterm outcomes from a number of centers are excellent and demonstrate the safety and durability of the procedure. Long-term outcomes and clinical trial data are necessary to determine which patients benefit the most from this procedure.

Sections du résumé

BACKGROUND
Aortic valve replacement is the traditional surgical treatment for aortic valve diseases, yet standardized aortic valve neocuspidization (AVNeo) is a promising alternative that is gaining popularity. The purpose of this article is to review the available published literature of AVNeo using glutaraldehyde-treated autologous pericardium, also known as the Ozaki procedure, including indications, outcomes, potential benefits, and modes of failure for the reconstructed valve.
METHODS
A comprehensive literature search was performed using keywords related to aortic valve repair, AVNeo, or Ozaki procedure. All articles describing performance of AVNeo were reviewed.
RESULTS
Reported early mortality after AVNeo varies from 0% to 5.88%. The largest cohort of patients in the literature includes 850 patients with an inhospital mortality rate of 1.88%. Cumulative incidence of aortic valve reoperation was 4.2% in the largest series. Reoperation was uncommon and mainly due to infective endocarditis or degeneration of the reconstructed valve (most commonly due to aortic valve regurgitation, rather than stenosis).
CONCLUSIONS
Aortic valve neocuspidization is a versatile and standardized alternative to aortic valve replacement with a biological prosthesis. Early to midterm outcomes from a number of centers are excellent and demonstrate the safety and durability of the procedure. Long-term outcomes and clinical trial data are necessary to determine which patients benefit the most from this procedure.

Identifiants

pubmed: 35439450
pii: S0003-4975(22)00518-5
doi: 10.1016/j.athoracsur.2022.03.067
pii:
doi:

Substances chimiques

Glutaral T3C89M417N

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1108-1117

Informations de copyright

Copyright © 2022 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Andrea Amabile (A)

Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

Markus Krane (M)

Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

Keith Dufendach (K)

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Christopher W Baird (CW)

Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Nikhil Ganjoo (N)

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Friedrich S Eckstein (FS)

Department of Cardiac Surgery, University Hospital Basel, University of Basel, Switzerland.

Alberto Albertini (A)

Cardiovascular Surgery Department, Maria Cecilia Hospital GVM Care and Research, Cotignola, Revenna, Italy.

Peter J Gruber (PJ)

Division of Cardiac, Thoracic, and Vascular Surgery, Section of Pediatric and Congenital Heart Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.

Mubashir A Mumtaz (MA)

University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania.

Emile A Bacha (EA)

Division of Cardiac, Thoracic, and Vascular Surgery, Section of Pediatric and Congenital Heart Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.

Umberto Benedetto (U)

Department of Cardiac Surgery, University Chieti-Pescara, Chieti, Italy.

Joanna Chikwe (J)

Department of Cardiac Surgery, Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, California.

Arnar Geirsson (A)

Division of Cardiac Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

Johannes Holfeld (J)

Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria.

Yasunori Iida (Y)

Department of Cardiovascular Surgery, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan.

Rüdiger Lange (R)

Department of Cardiovascular Surgery, German Heart Center, Munich, Germany.

Victor O Morell (VO)

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania.

Danny Chu (D)

Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania. Electronic address: chud@upmc.edu.

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Classifications MeSH