Aortic Valve Leaflets Reconstruction (Ozaki Procedure) in Aortic Valve Diseases
Aortic Valve Leaflets Reconstruction (Ozaki Procedure) in Aortic Valve Diseases
Prospective Cohort Study aims at elaborating the outcomes of the Tricuspid Reconstruction of
 Aortic valve leaflets using autologous pericardium (Ozaki procedure) in the adult and
 paediatric patients. A very promising technique with the potential benefits of dodging oral
 anticoagulation, foreign material, and suitable for patients with small aortic annuli and in
 infectious endocarditis.

 Performing hemodynamic evaluation, assess the clinical implementation and report preliminary
 results at follow up .
Heart valve disease signifies a severe growing public health problem in developing countries,
 with aortic valve stenosis being the most common issue. Heart valve disease is commonly
 initiated by atherosclerotic degenerative processes, congenital anomalies, or rheumatic
 process. Aortic valve replacement is the gold standard in the treatment of patients with
 severe aortic stenosis and aortic regurgitation. Mechanical valves are favoured in younger
 patients (<60 years) owing to longer life-time, whereas biological valves are used for
 elderly patients in order to evade oral anticoagulation.

 Options for aortic valve disease have improved in the last era including replacement, repair,
 and reconstructive options. A variety of creative techniques including leaflet extensions,
 neo-leaflet creation, resuspension or plication of prolapsing leaflets, and commissuroplasty
 to repair valves have been officially become skilled at, specially in pediatric population .
 In adults, the introduction of trans-catheter aortic valve inserting now permits treatment of
 degenerative aortic stenosis in the oldest and the highest risk patients. However, surgical
 treatment choices for pediatric patients with complex congenital aortic valve disease stay
 restricted.

 In recent years, much attention has been given to the Ozaki procedure, an alternative way of
 repairing aortic valve, involving the use of autologous pericardium for the aortic leaflet
 reconstruction. Diseased leaflets are removed carefully. The distance between each commissure
 is measured with invented sizing apparatus. The new leaflet of the size corresponding to the
 measured value is trimmed with an original template from glutaraldehyde-treated autologous
 pericardium. Finally, the annular margin of the pericardial leaflet was running sutured with
 each annulus. Commissural coaptation was secured with additional sutures. The coaptation of
 three new leaflets were always insured with direct vision.
Inclusion Criteria:

 -  Subject with AV disease.

 -  Documented symptomatic moderate or greater aortic stenosis

 -  small aortic annulus patients

 -  A symptomatic aortic insufficiency patient with left ventricular dysfunction or
 significant left ventricular dilatation.

 -  Patients with aortic regurgitation caused by: a dilated aortic annulus, conjoined cusp
 prolapse in bicuspid aortic valves (BAV), single cusp prolapse in tricuspid aortic
 valve (especially in paediatric population), and aortic valve cusp perforation from
 endocarditis.

 -  Concomitant intervention of the aortic root, Concomitant intervention of the aortic
 arch, Concomitant valve surgery and Concomitant intervention at congenital anomaly.

 Exclusion Criteria:

 -  Patients with previous aortic valve surgery.

 -  missing informed consent

 -  Participation in another clinical research.