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<p>Aortic valve replacement using glutaraldehyde-fixed autologous pericardium, as described by Shigeyuki Ozaki, represents a&#xa0;viable surgical alternative to the Ross procedure or prosthetic valve replacement in younger patients who are unable or unwilling to undergo lifelong oral anticoagulation. By implanting autologous pericardial cusps in the level of the native aortic annulus, this technique achieves a&#xa0;large effective orifice area and low transvalvular gradients, which is particularly advantageous in patients with a&#xa0;small annulus and a&#xa0;large body surface area. The feasibility of this technique depends on the absence of annular or aortic root dilatation, along with the availability of autologous pericardium of sufficient quality and durability. Due to its anatomical and hemodynamic characteristics, including laminar flow dynamics, the Ozaki procedure demonstrates excellent mid-term hemodynamic performance; however, data on the long-term durability remain limited. In addition to the favorable hemodynamic profile, the procedure is associated with low rates of stroke and permanent pacemaker implantation as well as excellent mid-term survival rates. The most frequent indication for a reoperation is infective endocarditis, with a&#xa0;0.3–1% risk per patient-year. Importantly, preservation of the native valvular annulus enables the feasibility of successive transcatheter valve-in-valve procedures in cases of structural valve deterioration, although available data are confined to individual case reports.</p>

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Der Aortenklappenersatz bei jungen Patienten und Patientinnen: die Ozaki-Technik

  • 期刊论文

  • 发表日期：

    2025年8月28日

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  • Benedikt Mayr,
  • Markus Krane

摘要

Aortic valve replacement using glutaraldehyde-fixed autologous pericardium, as described by Shigeyuki Ozaki, represents a viable surgical alternative to the Ross procedure or prosthetic valve replacement in younger patients who are unable or unwilling to undergo lifelong oral anticoagulation. By implanting autologous pericardial cusps in the level of the native aortic annulus, this technique achieves a large effective orifice area and low transvalvular gradients, which is particularly advantageous in patients with a small annulus and a large body surface area. The feasibility of this technique depends on the absence of annular or aortic root dilatation, along with the availability of autologous pericardium of sufficient quality and durability. Due to its anatomical and hemodynamic characteristics, including laminar flow dynamics, the Ozaki procedure demonstrates excellent mid-term hemodynamic performance; however, data on the long-term durability remain limited. In addition to the favorable hemodynamic profile, the procedure is associated with low rates of stroke and permanent pacemaker implantation as well as excellent mid-term survival rates. The most frequent indication for a reoperation is infective endocarditis, with a 0.3–1% risk per patient-year. Importantly, preservation of the native valvular annulus enables the feasibility of successive transcatheter valve-in-valve procedures in cases of structural valve deterioration, although available data are confined to individual case reports.