An ex vivo evaluation of two different suture techniques for the Ozaki aortic neocuspidization procedure. (5th June 2021)

• Record Type: Journal Article
• Authors: Saisho, Hiroyuki; Scharfschwerdt, Michael; Schaller, Tim; Reil, Jan Christian; Ensminger, Stephan; Fujita, Buntaro; Aboud, Anas
• Is Part Of: Interactive cardiovascular and thoracic surgery. Volume 33:Number 4(2021)
• Page Start: 518
• Page End: 524
• Publication Date: 2021-06-05
• Subjects: Ozaki procedure -- Aortic valve replacement -- Small aortic annulus -- Single suture technique -- Hydrodynamic performance; Chest -- Surgery -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; 616.1
• DOI: 10.1093/icvts/ivab138
• Languages: English
• ISSNs: 1569-9293

Abstract

Abstract: OBJECTIVES: We investigated the Ozaki procedure using a single interrupted suture technique (SST) and compared this with the standard continuous suture technique (CST) with regard to hydrodynamic valve performance. In addition, both techniques were compared with the native aortic valve (NAV). METHODS: Effective orifice area, mean pressure gradient and leakage volume were evaluated in the NAV as well as after an Ozaki procedure using SST or CST in fresh swine aortic roots using a mock circulation loop. The NAV, SST and CST were evaluated under 4 defined hydrodynamic conditions. RESULTS: Both suture techniques resulted in a similar effective orifice area under all conditions [for stroke volume of 70 ml: SST: 1.50 (1.35–1.87) vs CST: 1.57 (1.41–1.72) cm 2, P = 0.8] and there were no significant differences between both suture techniques and the NAV ( P > 0.05). Regarding mean pressure gradient, the Ozaki procedure with SST and CST showed no significant differences [7.23 (5.53–8.91) vs 7.04 (6.65–7.60) mmHg, P = 0.72] and there was no significant difference between both suture techniques and the NAV ( P > 0.1). In leakage volume, there was no significant difference between SST and CST [4.49 (3.91–4.99) vs CST: 4.23 (3.58–4.87) ml/stroke, P = 0.34]. CONCLUSIONS: The Ozaki procedure with SST performed similarly to that with CST with regard to hydrodynamic performance. Our results suggest that the Ozaki procedure can be performed with SST instead of CST, which may be useful in patients with limited surgical exposure, such as a small annulus. Abstract : Surgical aortic valve replacement with established prosthetic valves has been the gold standard for the treatment of aortic valve disease and is still the treatment of choice in young patients [1, 2].