Ozaki Procedure through a J-ministernotomy: Single Center Experience

Evgeny Rosseykin, Evgeny Kobzev, Vladlen Bazylev

Federal Center of Cardiovascular surgery, Penza, Russia

Date, time and location: 2018.05.27 10:30, Congress Hall, 2F–C

Abstract

Objective: The aim of this study was to compare clinical outcomes aortic valve reconstruction using autologus pericardium (Ozaki procedure)trough a J-ministernotimy or full sternotomy.

Materials and methods.Between October 2015 and December 2017, a total of 338 patients underwent Ozaki procedure at our institution.In 7,1% (n=24), the less invasive partial J-ministernotomy was used (group 1). In control group 2 (n=144) was used full sternotomy. Exclusion criteria in control group were: mitral valve, tricuspid valve and aortic arch surgery, radiofrequency ablation, circumflex and distal segments right coronary artery disease.

Results. The 30-day mortality in group 1 was 4.2% (n=1), in group 2 – 0,7% (n=1). CPB and aortic cross-clamp times were significantly shorter in the conventional group (134±26 min versus 154±30 min, p<0,001 and 107±19 versus 119±19,р=0,005 respectively). However, in Group 2, blood loss and reexploration for bleeding was higher (561±198 ml versus 382±237 ml, p<0,001 and 3,5%, n=5 versus 0, p=0,35 respectively). Mechanical ventilation, ICU and total hospital stay were significantly less in group 1 (7±5,6 hours versus 10,3±3,2 hours,р<0,001; 2,3±1,0 days versus 3,2±1,7, h=0,01; 8,8±2,9 day versus 10,7±4,1, h=0,03). In Group 2, one patient (0,7%) developed deep sternal wound infection, and two patient (1,4%) suffered unstable sternum. In Group 1, there were no such incidents. Implantation of a permanent pacemaker was required for one patient in each group.

Conclusion. Ozaki procedure can be safely conducted through a partial J-ministernotomy. This approach is not associated with an increased rate of complications.