[Aortic Valve Neocuspidization Using the Ozaki Technique: An Alternative Approach for Valve Replacement]

Aortic valve neocuspidization, as described by Dr. Ozaki, is a surgical technique that uses the patient's own pericardium to reconstruct the aortic valve leaflets. To evaluate the operative and short-term outcomes in the first adult patients treated with this technique.

This prospective study included patients who underwent aortic valve neocuspidization between March 2019 and December 2024 (n=61) at Guillermo Grant Benavente Hospital, Concepción, Chile. Operative outcomes, survival, need for reintervention, as well as clinical and echocardiographic results, were assessed through July 31, 2025.

Of the 61 patients, 43 were male, with a mean age of 52.6±12.3 years. Aortic stenosis was the most common pathology, present in 45 patients. Nine patients had active endocarditis. The mean preoperative left ventricular ejection fraction was 57.1±12.2%. All procedures were elective. Eight patients underwent additional procedures (3 coronary artery bypass surgeries, 3 mitral valve repairs, 1 tricuspid valve repair, and 1 ventricular septal defect closure). Two cases required conversion to prosthetic valve replacement. There was no operative mortality. The mean follow-up duration was 34±14.4 months. The maximum transvalvular gradients at 6, 12, 24, and 36 months were 10.7, 13.5, 14.3, and 21.5 mmHg, respectively. Four patients developed moderate-to-severe regurgitation (> grade 3). Three patients required reoperation at 2, 4, and 7 months postoperatively. There were two deaths during the follow-up period. The estimated 5-year survival free from major cardiovascular events (death, regurgitation > grade 3, endocarditis, or reoperation) was 78.9%.

Aortic valve neocuspidization using the Ozaki technique is a reproducible procedure with a low rate of complications. It may serve as an effective alternative treatment for selected patients with aortic valve disease.