Short term Echocardiographic and clinical assessment of aortic valve neo-cuspidization (Ozaki procedure) in comparison with mechanical aortic valve replacement

Amr Mohamed Ahmed Elshabrawy, Department of cardiovascular medicine, Faculty of Medicine, Mansoura University.Follow
Mohamed A. Gabr, Department of cardiothoracic surgery, Faculty of Medicine, Mansoura University
Eid M Daoud, Department of cardiovascular medicine, Faculty of Medicine, Mansoura University
Mohammed Sanad, Department of cardiothoracic surgery, Faculty of Medicine, Mansoura University
Sherif Arafa, Department of cardiovascular medicine, Faculty of Medicine, Mansoura University

Corresponding Author

Correspondence to Amr M.A. Elshabrawy, MB, BCh, Department of Cardiovascular Medicine, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia 35651, Egypt. E-mail: [email protected]. Tel: +20 100 346 8024.

Subject Area

Cardiology

Article Type

Original Study

Abstract

Background: Aortic valve neo-cuspidization (AVNeo, Ozaki procedure) has emerged as an alternative to conventional aortic valve replacement, aiming to preserve native aortic root dynamics and improve postoperative hemodynamics. The replacement of the aortic valve presents challenges because both biological and mechanical prostheses have notable limitations.

Aim: To evaluate the short-term clinical and echocardiographic outcomes of aortic valve neocuspidization (Ozaki procedure) compared with mechanical aortic valve replacement (AVR) in patients with isolated aortic valve disease.

Patients and methods: This prospective comparative observational study included 42 adult patients with isolated aortic valve disease. 20 patients underwent AVNeo (Ozaki procedure) and 22 underwent mechanical aortic valve replacement. Echocardiographic assessment included aortic valve area (AVA), transvalvular pressure gradients, degree of aortic regurgitation, and left ventricular parameters. The operative technique was standardized for all patients according to the groups. The primary outcomes were change in the trans-aortic pressure gradients measured, change in the aortic valve area and presence and degree of aortic regurgitation by echocardiography.

Results: Postoperatively, the AVNeo group demonstrated a significantly larger AVA and lower peak and mean transvalvular pressure gradients compared with the mechanical aortic valve replacement group. Significant improvement was observed in both groups regarding echocardiographic parameters. Mild aortic regurgitation was less frequent in the AVNeo group.

Conclusion: Both procedures resulted in significant early echocardiographic improvement. AVNeo demonstrated favorable early hemodynamic performance compared with mechanical aortic valve replacement. Further studies with larger cohorts and longer follow-up are required to evaluate long-term durability and clinical outcomes.

Recommended Citation

Elshabrawy, Amr Mohamed Ahmed; Gabr, Mohamed A.; Daoud, Eid M; Sanad, Mohammed; and Arafa, Sherif (2026) "Short term Echocardiographic and clinical assessment of aortic valve neo-cuspidization (Ozaki procedure) in comparison with mechanical aortic valve replacement," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 20.
Available at: https://doi.org/10.58775/2735-3990.1597