Comparison of the results of aortic valve neocuspidalization (OZAKI procedure) with aortic valve bioprosthetics in patients with a narrow aortic annulus: a multicenter retrospective study

In aortic valve (AV) replacement surgery in patients with a narrow annulus fibrosus (AF), the likelihood of prosthesis-patient mismatch (PPM) is high. PPM, in turn, significantly affects the hemodynamic and functional capabilities of AV, morbidity and mortality in the postoperative period. The “gold standard” for the treatment of AV diseases is prosthetics with mechanical and biological prostheses. However, there are alternative methods, such as neocuspidalization of AV according to the S. Ozaki (AVNeo) method.Aim: To compare the immediate and medium-term results of AV prosthetics using the S. Ozaki (AVNeo) technique and AV prosthetics with a biological prosthesis in patients with a small aortic annulus.Material and Methods: A retrospective multicenter study of 309 patients with a narrow fibrous ring of the aortic valve (FR AV) who underwent surgery between February 2010 and December 2021 was conducted. Inclusion criteria: prosthetics of AV, FR AV = 21 mm, age 18 years and older. Exclusion criteria: left ventricle ejection fraction ≤ 40%, repeated interventions, mini-stop. 153 patients underwent Aveo and 156 patients underwent AV prosthetics using biological prostheses. After “pseudorandomization” (propensity score matching), 92 patients were selected: 46 patients in the AVNeo group and 46 patients in the biological prosthesis group. The primary endpoint was hospital mortality. Postoperative complications, transvalvular gradients, and medium-term outcomes (three-year overall survival and freedom from surgery on AV) were evaluated as secondary endpoints.Results. There was no statistically significant difference in the duration of surgery (275.9 ± 34.2 min in the AVNeo group and 285.8 ± 37 min in the bioprosthesis group, p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }