PDF(Pubmed)
Abstract：
The Ozaki procedure has emerged as a valuable option for treating various aortic valve pathologies. This review article delves into the intricacies of this innovative surgical approach by exploring its adaptation to the complex anatomy and physiology of the aortic root. The diverse etiologies of aortic valve diseases, ranging from congenital anomalies to degenerative changes, make treatment selection a complex challenge. Aortic valve replacement has traditionally been the gold standard, but emerging evidence supports valve repair techniques, emphasizing the importance of preserving native tissue. Nevertheless, issues like lifelong anticoagulation with mechanical valves and patient-prosthetic mismatch remain. The Ozaki procedure offers a compelling alternative by utilizing autologous pericardium or a tissue substitute to construct new aortic valve leaflets. This technique, standardized by Dr. Ozaki in 2007, provides a customizable and adaptable solution. The article highlights the anatomy of the aortic root, emphasizing the critical role of the sinus of Valsalva and interleaflet triangles in maintaining proper valve function. The procedure\'s unique adaptation to aortic root dynamics allows for reduced mechanical stress during systole and diastole, mimicking the natural valve\'s behavior. Furthermore, Ozaki leaflets exhibit promising hemodynamics and reduced risks of complications, such as permanent pacemaker implantation and patient-prosthetic mismatch. The use of autologous pericardium in the Ozaki procedure presents advantages, including enhanced tissue strength, minimal immunogenicity, and reduced risk of immune-mediated calcification. These factors contribute to the longevity and resilience of the reconstructed valve. This comprehensive review aims to shed light on the procedure\'s intricacies, its alignment with aortic root anatomy and physiology, and its potential as a valuable tool in the armamentarium of aortic surgeons.
摘要：
Ozaki手术已成为治疗各种主动脉瓣病变的有价值的选择。本文通过探索这种创新手术方法对主动脉根复杂解剖和生理的适应性，探讨了这种创新手术方法的复杂性。主动脉瓣疾病的不同病因，从先天性异常到退行性改变，使治疗选择成为一个复杂的挑战。主动脉瓣置换术传统上是黄金标准，但是新出现的证据支持瓣膜修复技术，强调保存天然组织的重要性。然而，像终身抗凝与机械瓣膜和患者-假体不匹配的问题仍然存在。Ozaki手术通过利用自体心包或组织替代物构建新的主动脉瓣小叶提供了令人信服的替代方案。这项技术,2007年由Ozaki博士标准化，提供可定制和适应性强的解决方案。文章重点介绍了主动脉根部的解剖结构,强调Valsalva窦和交错三角形在维持正常瓣膜功能中的关键作用。该手术对主动脉根动力学的独特适应允许在收缩期和舒张期减少机械应力,模仿自然瓣膜的行为。此外，Ozaki小叶表现出良好的血流动力学和并发症的风险降低，如永久性起搏器植入和患者-假体不匹配。在Ozaki手术中使用自体心包具有优势，包括增强的组织强度，最小的免疫原性，并降低免疫介导的钙化风险。这些因素有助于重建瓣膜的寿命和弹性。这项全面的审查旨在阐明该程序的复杂性，它与主动脉根解剖和生理学对齐，以及它作为主动脉外科医生医疗设备中一个有价值的工具的潜力。
