In:
Patologiya krovoobrashcheniya i kardiokhirurgiya, Meshalkin National Medical Research Center, Vol. 25, No. 4 ( 2021-12-28), p. 53-
Abstract:
〈 p 〉 〈 strong 〉 Background. 〈 /strong 〉 Currently, aortic valve stenosis is the most common disease of the native valve, which affects 5% of the elderly population. In symptomatic patients, aortic valve replacement is the ‘gold standard’. For patients aged ≥65 years, the use of biological prostheses is recommended. The Ozaki operation is an alternative to bioprostheses. 〈 /p 〉 〈 p 〉 〈 strong 〉 Aim. 〈 /strong 〉 The aim of this study was to evaluate the immediate and 3-year results of Ozaki surgery in patients aged ≥65 years. 〈 /p 〉 〈 p 〉 〈 strong 〉 Methods. 〈 /strong 〉 This was a prospective multicentre study conducted on 107 patients aged ≥65 years, who underwent the Ozaki procedure at three centres during 2016–2019. There were 46 (43%) men. The median age of the patients was 69 [67–74] years. Severe aortic stenosis was the major cause of aortic valve dysfunction (106 patients [99.1%] ). Chronic heart failure III–IV functional class according to NYHA was diagnosed in 47 (43.9%) patients. The following complications were also registered: atrial fibrillation in 30 (28%) patients, a history of diabetes mellitus in 16 (15%) patients, chronic obstructive pulmonary disease in 14 (13.1%) patients and coronary artery disease in 42 (39.2%) patients. Bicuspid aortic valve was detected in 36 (34.6%) patients. There were 72 (67.2%) patients with a small annulus (≤21 mm) and 59 (55.14%) patients with a left ventricular ejection fraction of 64%. The median follow-up period was 23 [18–33] months. This study included all patients who underwent Ozaki surgery from 2016 to 2019. 〈 /p 〉 〈 p 〉 〈 strong 〉 Results. 〈 /strong 〉 No patient had any conversions. A total of 45 (42.1%) patients underwent combined interventions. The operation duration was 240 [214–300] min, cardiopulmonary bypass duration was 104 [93–120] min and aortic cross-clamp duration was 82 [72–95] min. The rate of hospital mortality was 1.9%, and the incidence rates of acute renal failure requiring haemodialysis, stroke, pacemaker implantation, sepsis and reoperation for bleeding were 1.9%, 0.9%, 1.9%, 0.9% and 0.9%, respectively. The hospitalisation duration was 14 [11–16] days. The gradients of peak and mean pressure on the aortic valve after surgery were 9 [7–13] and 4 [3–6] mmHg, respectively, and the effective valve opening area was 2.6 [2.3–2.9] cm 〈 sup 〉 2 〈 /sup 〉 . None of the patients had moderate and severe aortic regurgitation. The 3-year overall survival and freedom from reoperation were 88.6% and 97%, respectively. 〈 /p 〉 〈 p 〉 〈 strong 〉 Conclusion. 〈 /strong 〉 The Ozaki operation in patients aged ≥65 years has good immediate results, with a hospital mortality rate of 1.9%, excellent haemodynamic parameters with an average pressure gradient across the aortic valve of 4 [3–6] mmHg and a valve opening area of 2.6 [2.3–2.9] cm 〈 sup 〉 2 〈 /sup 〉 . The 3-year overall survival and freedom from reoperation were 88.6% and 97%, respectively. Further monitoring of these patients is required to evaluate long-term results, and there is also a need for randomised clinical trials comparing Ozaki operation with bioprostheses. 〈 /p 〉 〈 p 〉 Received 4 February 2021. Revised 21 June 2021. Accepted 23 June 2021. 〈 /p 〉 〈 p 〉 〈 strong 〉 Funding: 〈 /strong 〉 The study did not have sponsorship. 〈 /p 〉 〈 p 〉 〈 strong 〉 Conflict of interest: 〈 /strong 〉 Authors declare no conflict of interest. 〈 /p 〉 〈 p 〉 〈 strong 〉 Contribution of the authors 〈 br / 〉 〈 /strong 〉 Conception and study design: I.I. Chernov, R.N. Komarov, D.G. Tarasov, Yu.S. Sinelnikov, A.V. Marchenko, V.B. Arutyunayan, K.Yu. Zhigalov 〈 br / 〉 Data collection and analysis: B.K. Kadyraliev, A.M. Ismailbaev, B.M. Tlisov, D.A. Zorin, M.I. Tcheglov 〈 br / 〉 Statistical analysis: S.T. Enginoev 〈 br / 〉 Drafting the article: I.I. Chernov, S.T. Enginoev 〈 br / 〉 Critical revision of the article: I.I. Chernov, R.N. Komarov, D.G. Tarasov, Yu.S. Sinelnikov, A.V. Marchenko, V.B. Arutyunayan, K.Yu. Zhigalov 〈 br / 〉 Final approval of the version to be published: I.I. Chernov, S.T. Enginoev, R.N. Komarov, D.G. Tarasov, Y.S. Sinelnikov, A.V. Marchenko, V.B. Arutyunayan, B.K. Kadyraliev, A.M. Ismailbaev, B.M. Tlisov, D.A. Zorin, M.I. Tcheglov, K.Yu. Zhigalov 〈 /p 〉
Type of Medium:
Online Resource
ISSN:
2500-3119
,
1681-3472
DOI:
10.21688/1681-3472-2021-4
DOI:
10.21688/1681-3472-2021-4-53-63
Language:
Unknown
Publisher:
Meshalkin National Medical Research Center
Publication Date:
2021
detail.hit.zdb_id:
3069467-X
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