Immediate and long-term results of aortic valve replacement with biological prosthesis and Ozaki procedure in patients with severe aortic stenosis, reduced ejection fraction and low transaortic pressure gradient

Bazylev V.V.; Batrakov P.A.; Babukov R.M.; Bartosh F.L.; Mikulyak A.I.; Karnakhin V.A.; Levina A.V.

doi:https://doi.org/10.17116/kardio202316051481

Bazylev V.V.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0001-6089-9722

Batrakov P.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7270-4977

Babukov R.M.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7338-9462

Bartosh F.L.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0001-5482-3211

Mikulyak A.I.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-9519-5036

Karnakhin V.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-1815-7116

Levina A.V.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-3210-3974

Immediate and long-term results of aortic valve replacement with biological prosthesis and Ozaki procedure in patients with severe aortic stenosis, reduced ejection fraction and low transaortic pressure gradient

Authors:

Bazylev V.V., Batrakov P.A., Babukov R.M., Bartosh F.L., Mikulyak A.I., Karnakhin V.A., Levina A.V.

More about the authors

Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(5): 481‑490

DOI: 10.17116/kardio202316051481

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To cite this article:

Bazylev VV, Batrakov PA, Babukov RM, Bartosh FL, Mikulyak AI, Karnakhin VA, Levina AV. Immediate and long-term results of aortic valve replacement with biological prosthesis and Ozaki procedure in patients with severe aortic stenosis, reduced ejection fraction and low transaortic pressure gradient. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(5):481‑490. (In Russ.)
https://doi.org/10.17116/kardio202316051481

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To compare the immediate and long-term results in patients with low flow aortic stenosis, reduced transaortic pressure gradient and left ventricular (LV) ejection fraction after aortic valve replacement with biological prosthesis and Ozaki procedure.

MATERIAL AND METHODS

We identified all patients meeting the criteria for severe symptomatic low flow aortic stenosis with reduced pressure gradient and LV ejection fraction. Patients underwent either aortic valve replacement with biological prosthesis (between October 2015 and December 2020) or Ozaki procedure (between October 2015 and December 2020). The study included all patients meeting the following echocardiography criteria: mean pressure gradient <40 mm Hg and maximum blood flow velocity <4 m/s, LV ejection fraction <50%, indexed stroke volume <35 ml/m². All patients were divided into 2 groups: group 1 — 64 patients with biological prostheses (mean age 65±5 years); group 2 — 60 patients after Ozaki procedure (mean age 64±7 years). All patients underwent transthoracic and transesophageal echocardiography in accordance with modern guidelines.

RESULTS

Moderate prosthesis-patient mismatch was found in 29 (46%) patients after aortic valve replacement with biological prosthesis. There were no similar cases after Ozaki procedure. Long-term all-cause mortality was similar (37% vs. 27%, p=0.3).

CONCLUSION

Five-year survival after aortic valve replacement with biological prosthesis and Ozaki procedure is similar in patients with low flow aortic stenosis, reduced transaortic pressure gradient and LV ejection fraction. Aortic valve replacement with biological prosthesis is followed by higher risk of thromboembolic events and admissions for exacerbation of chronic heart failure in long-term period. In-hospital mortality is significantly higher after Ozaki procedure.

Keywords:

aortic valve

Ozaki procedure

Authors:

Bazylev V.V.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0001-6089-9722

Batrakov P.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7270-4977

Babukov R.M.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-7338-9462

Bartosh F.L.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0001-5482-3211

Mikulyak A.I.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-9519-5036

Karnakhin V.A.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-1815-7116

Levina A.V.

Federal Center for Cardiovascular Surgery

ORCID: 0000-0002-3210-3974

Received:

02.11.2022

Accepted:

24.04.2023

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References:

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