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Ozaki technique versus Ross operation for complex aortic valve diseases in children: a retrospective cohort study

Guan-Xi Wang1, Sen Zhang1, Kai Ma1

  • 1Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District.

International Journal of Surgery (London, England)
|July 18, 2024
PubMed

Insights

The Ozaki technique showed poorer mid-term durability than the Ross operation for pediatric complex aortic valve disease, with higher rates of aortic regurgitation and stenosis, particularly in younger patients.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Aortic Valve Disease

Background:

  • The Ozaki technique shows promise in adults, but its efficacy in pediatric patients with complex aortic valve diseases is less understood.
  • Limited follow-up data exists for the Ozaki technique in children.

Purpose of the Study:

  • To compare the mid-term results of the Ozaki technique versus the Ross operation for complex aortic valve diseases in pediatric patients.
  • To evaluate the incidence of moderate or severe aortic regurgitation/stenosis post-procedure.

Main Methods:

  • A cohort of 117 children underwent either the Ozaki (n=64) or Ross (n=53) operation between January 2017 and December 2023.
  • The primary endpoint was the incidence of moderate or severe aortic regurgitation or stenosis post-procedure.
  • Mid-term follow-up data was collected and analyzed.

Main Results:

  • The Ozaki group had a higher incidence of moderate or severe aortic regurgitation (28.1% vs. 3.1%) and stenosis (31.3% vs. 5.7%) compared to the Ross group.
  • Five patients (7.8%) in the Ozaki group required reoperations, versus none in the Ross group.
  • Lower age and need for ECMO installation were identified as risk factors for moderate or severe aortic regurgitation in the Ozaki group.

Conclusions:

  • The Ozaki technique may serve as a palliative option for pediatric complex aortic valve diseases.
  • However, its mid-term durability is inferior to the Ross operation, especially in younger children.
  • Further research is needed to optimize the Ozaki technique for pediatric use.
Abstract

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