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Subclinical leaflet thrombosis in Ozaki procedure
Mathieu van Steenberghe1,2, Francois Perret3, Patrick O Myers4
1Cardiovascular Surgery Unit, Cecil Clinic, Lausanne, Switzerland.
Interdisciplinary Cardiovascular and Thoracic Surgery
|March 4, 2025
Summary
Subclinical leaflet thrombosis (SLT) can occur after aortic valve reconstruction using the Ozaki procedure. Early anticoagulation improved leaflet mobility and hemodynamics, suggesting its potential benefit in managing this complication.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Cardiology
Background:
- The Ozaki procedure, using autologous glutaraldehyde-fixed pericardium for aortic valve reconstruction, offers excellent hemodynamic outcomes.
- Subclinical leaflet thrombosis (SLT) is a known complication of conventional bioprosthetic valves.
Purpose of the Study:
- To report the first cases of subclinical leaflet thrombosis (SLT) in adult patients following the Ozaki procedure.
- To evaluate the efficacy of anticoagulation in managing SLT after Ozaki aortic valve reconstruction.
Main Methods:
- Case report of two adult patients who developed SLT post-Ozaki procedure at 12 and 23 months.
- Initiation of anticoagulation therapy and subsequent echocardiographic monitoring.
Main Results:
- Both patients presented with subclinical leaflet thrombosis (SLT).
- Anticoagulation therapy led to improved leaflet mobility and hemodynamic function on echocardiography.
- This is the first reported instance of SLT in adults undergoing the Ozaki procedure.
Conclusions:
- Subclinical leaflet thrombosis (SLT) is a potential complication of the Ozaki procedure, similar to other bioprosthetic valves.
- Anticoagulation may be beneficial for managing SLT after Ozaki aortic valve reconstruction.
- Further research into alternative treatments to glutaraldehyde and optimal anticoagulation strategies is warranted.
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