Minimally Invasive Ozaki Procedure in Severe Aortic Regurgitation: the Preliminary Results

Dinh Nguyen, Anh T. Vo, Thanh T. Vu, Trang Nguyen, Thien Vu, Chuong Pham, Tuan Anh T. Pham, Khoi Le

University medical center of Ho Chi Minh City, Ho Chi Minh City, Viet Nam

Date, time and location: 2018.05.26 17:00, Exhibition area, 1st Floor. Zone – C

Abstract

Background: The Ozaki procedure for aortic valve reconstruction has been reported in 2014 with a very low mortality,  a good midterm result, long term result is being followed with a promising outcome. However, the procedure was still requiring the conventional sternotomy to be accomplished. The development of minimally invasive valvular surgery has created the stimulation to combine the advantages of these two advances to provide a better modality for patients. We reported 7 first cases of ministernotomy Ozaki procedure in our center.

Objective and method: To determine the safety and feasibility of minimally invasive Ozaki technique. From 01/06/2017 to 01/12/2017, 7 patients with severe aortic valve regurgitation underwent minimally invasive Ozaki procedure through an upper ministernotomy approach at the University Medical center of Ho Chi Minh City, Vietnam. The pericardium was harvested endoscopically. Then, a ministernotomy was performed and the Ozaki procedure was accomplished similar to the conventional techinique. We analyzed the in-hospital mortality and complications of this group.

Results: The mean age was 47.4. 4 patients were female (57.1%). The predominant pathology was chornic rheumatic valve disease (5 patients), 2 other patients were diagnosed with biscupid aortic valve (28.6%). Mean aortic cross clamp time was 96.8 minute, mean cardiopulmonary bypass time was 142.6 min, mean ventilation time was 8.4 hours and mean ICU time was 1.6 days. No mortality was recorded in our series, no conversion to full sternotomy was required, one patients had right hemothorax requiring drainage. Intraoperative TEE showed 5 competent valves and 2 valves with trivial regurgitation, no stenosis was detected. The results was reconfirmed by transthoracic echocardiography before discharge.

Conclusion: The combination between the Ozaki procedure and minimally approach can be performed safely and effectively with few periopeartive complications. Further assessment and bigger data are needed.