OBJECTIVE

To determine the predictors of aortic valve dysfunction after Ozaki procedure.

MATERIAL AND METHODS

A retrospective study included all patients (n=539) who underwent Ozaki procedure between 2015 and 2018. Isolated aortic valve replacement and concomitant procedures with coronary artery bypass grafting and/or mitral valve surgery were performed. All interventions were performed under cardiopulmonary bypass and normothermia through median sternotomy or J-shaped partial sternotomy (4%).

RESULTS

Redo surgery for aortic insufficiency was required in 16 (2.9%) patients. Infective endocarditis caused valve dysfunction in 3 (18%) cases. In other cases, recurrent aortic insufficiency was due to prolapse of the right coronary or non-coronary leaflets. Freedom from redo surgeries throughout 5 years was 97±1%. According to Cox regression, two predictors influencing long-term results were identified. For each millimeter of aortic annulus size, the risk of redo surgery increases by 60% with each month after surgery. Leaflet symmetry reduces the risk of redo surgery by 90% with each month. Multilayer perceptron allowed us to identify several significant predictors of redo surgery: leaflet asymmetry, size of sinotubular junction, sinuses of Valsalva and aortic annulus. The main predictor of long-term results is leaflet asymmetry. Other ones are twice as important and have the same effect on postoperative results.