الفهرس | Only 14 pages are availabe for public view |
Abstract Autologous pericardial aortic valve reconstruction is an attractive option compared with metallic prosthetic valve replacement due to the absence of anticoagulation, lower pressure gradient across the valve and excellent valve haemodynamics. Objective: We wanted to detect the early outcome differences between aortic valve replacement by pretreated autologous pericardium via Ozaki procedure and metallic prosthetic valves. Patients and methods: Between November 2019 to August 2021, 40 patients undergoing aortic valve replacement in Kasr Alainy and Kasr Alainy-affiliated hospitals. Patients were divided into 2 equal groups: AVR group: 20 cases of aortic valve disease requiring metallic aortic valve replacement and Ozaki group: 20 cases of aortic valve disease requiring aortic valve replacement by Ozaki technique. A comprehensive echocardiographic evaluation was done pre-discharge and at one, three and six months after surgery. Aortic valve pressure gradient as well as other perioperative parameters were also evaluated like cardiopulmonary bypass and cross-clamp time, need for anticoagulation etc. Results: No significant differences between studied groups regards to demographic, comorbidies risk factors and baseline echocardiographic findings. Prolonged CPB (75.00±9.31 vs 59.25±6.54 mins) and aortic cross-clamp time was (57.750±8.80 vs 44.50±3.94 mins) in Ozaki than prosthetic aortic valve replacement respectively with p value <0.01. There were no significant differences between studied groups regards to intraoperative EF% (50.25±7.58 vs 47.95±6.58 %), mean pressure gradient (10.45±1.05 vs 9.75±1.29 mmHg) and peak pressure gradient (20.05±1.92 vs 19.25±2.33 mmHg), duration of ventilation (7.90±1.20 vs 8.65±3.03 hours), ICU stays (45.25±4.11 vs 51.85±30.43 hours) for mechanical valve replacement and Ozaki group respectively. None of enrolled patients in current study complaining of early postoperative complications, conduction abnormalities and none of them required anticoagulation. No incidence of reoperation with no mortality rate during a period of follow up. Conclusion: Autologous pericardial aortic valve reconstruction by Ozaki technique feasible alternative to metallic prosthetic valve replacement with good haemodynamics, no anticoagulation and maintenance of lower pressure gradient across the implanted valve. |