Indications of aortic valve reconstruction surgery by Ozaki procedure
The mean age of our study cohort was 52.9 with the youngest was only 19 years old and 38.9% was under 50. These patients would have been indicated to receive mechanical aortic valve replacement according to AHA recommendations.14 However, we decided to perform the Ozaki procedure due to the following reasons: (1) In developing countries including Vietnam, it is difficult to administer and monitor anticoagulants especially for patients in remote areas and ethnic minorities. (2) The studies reported by Ozaki and Lida suggested that the group of young patients had a low rate of reconstructed valve impairment during a mid-term follow-up.15,16
The advantage of Ozaki’s technique was the total resection of the diseased cusps; therefore, it could be implemented to different types of aortic valve disease including stenosis, regurgitation, and a combination of both.11 The previous approaches such as cusps expansion all have some limitations in the case of aortic stenosis.
Other authors (Ozaki et al.11 and Krane et al.17) performed aortic valve reconstruction in cases of both isolated aortic valve disease and in combination with other surgeries such as coronary artery bypass graft (CABG), mitral valve repair or replacement. Nevertheless, our study enrolled only patients with isolated aortic valve disease because (1) With a new technique, the selection of isolated AVD would reduce surgical and aortic cross-clamp time; (2) Outcomes evaluation would not be influenced by various factors.