Short-term outcomes of the tiara bioprosthesis and the Ozaki procedure comparison: a multicenter retrospective study with propensity score analysis

Cardiac surgery research shows that isolated aortic valve (AV) procedures account for 9% of all cardiac surgeries, with a surgery mortality rate of 2.3% and the predominance of bioprosthese use. Despite the widespread use of these methods, there is a high rate of patient-prosthesis mismatch affecting long-term survival. In this context, new technologies are emerging, such as Tiara bioprostheses and Ozaki neocuspidization of AV, but their comparative analysis is currently lacking.Aim: to compare short-term outcomes of the Tiara bioprosthesis implantation and the Ozaki procedure.Methodology and Research Methods. Retrospective analysis of 387 patients who underwent Ozaki procedure or the Tiara bioprosthesis implantation was performed. Inclusion criteria are patient age 18 years or older, Ozaki procedure performed or the Tiara bioprosthesis implantation. Exclusion criteria are use of a mini-access, the presence of infective endocarditis and repeated cardiac surgery. Ultimately, 352 patients were selected. Given the statistically significant differences in clinical and demographic characteristics between the groups, a propensity score matching was used in a 1 : 1 ratio. As a result two balanced groups of 58 patients each were formed.Results. In the group, where the Tiara bioprosthesis was implanted, the average age was 69 ± 5 years. In the group, where the Ozaki procedure was performed, the average age was 68 ± 6 years (p = 0.3). There were 14 men and 44 women in the Tiara group and 21 men and 37 women in the Ozaki group (p = 0.1). The median diameter of the annulus in the Tiara group was 20 (20-22) mm, while in the Ozaki group it was 21 (20-22) mm (p = 0.2). Statistically significant differences were noted in the duration of the surgery, cardiopulmonary bypass and cross-clamp time, which were statistically less in the Tiara group compared to the Ozaki group: surgery duration - 160 (145-199) minutes versus 250 (220-295) minutes (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }