Abstract：
BACKGROUND: Trileaflet aortic valve neocuspidization (AVN) using autologous pericardium (Ozaki procedure) is an emerging surgical treatment option for aortic valve diseases. Although excellent results have been reported from Japan, data pertaining to its use in the United States are sparse.
METHODS: All adult patients who underwent AVN (AVN group) or surgical aortic valve replacement (SAVR) with a bioprosthetic valve (SAVR group) between 2015 and 2022 were identified. Propensity score matching was used to adjust the baseline characteristics between the 2 groups.
RESULTS: A total of 101 patients underwent AVN, and 1816 patients underwent SAVR with a bioprosthetic valve. None in the AVN group required conversion to SAVR. Before matching, mean age in the AVN group was 68.5 ± 8.8 years, and 56 patients (55.4%) underwent concomitant procedures. Preoperatively, 3 (3%) had endocarditis. Bicuspid valve was observed in 38 (38.4%). None died at 30 days in the AVN group. The median follow-up duration was 3.2 years. After propensity score matching, the expected survival and freedom from at least moderate aortic regurgitation at 5 years was 91.7% ± 3.1% and 97.6% ± 1.7%, respectively. Propensity score matching yielded 77 patients in each group. The Kaplan-Meier curve demonstrated equivalent survival at 5 years between the 2 groups (P = .95). Additionally, freedom from at least moderate aortic regurgitation was comparable at 5 years (P = .23).
CONCLUSIONS: AVN can be safely performed for a variety of aortic valve diseases, with or without concomitant operations. AVN demonstrated similar midterm outcomes compared with SAVR with a bioprosthetic valve in the United States adult population.
METHODS: All adult patients who underwent AVN (AVN group) or surgical aortic valve replacement (SAVR) with a bioprosthetic valve (SAVR group) between 2015 and 2022 were identified. Propensity score matching was used to adjust the baseline characteristics between the 2 groups.
RESULTS: A total of 101 patients underwent AVN, and 1816 patients underwent SAVR with a bioprosthetic valve. None in the AVN group required conversion to SAVR. Before matching, mean age in the AVN group was 68.5 ± 8.8 years, and 56 patients (55.4%) underwent concomitant procedures. Preoperatively, 3 (3%) had endocarditis. Bicuspid valve was observed in 38 (38.4%). None died at 30 days in the AVN group. The median follow-up duration was 3.2 years. After propensity score matching, the expected survival and freedom from at least moderate aortic regurgitation at 5 years was 91.7% ± 3.1% and 97.6% ± 1.7%, respectively. Propensity score matching yielded 77 patients in each group. The Kaplan-Meier curve demonstrated equivalent survival at 5 years between the 2 groups (P = .95). Additionally, freedom from at least moderate aortic regurgitation was comparable at 5 years (P = .23).
CONCLUSIONS: AVN can be safely performed for a variety of aortic valve diseases, with or without concomitant operations. AVN demonstrated similar midterm outcomes compared with SAVR with a bioprosthetic valve in the United States adult population.
摘要：
背景：使用自体心包（Ozaki手术）的Trileaflet主动脉瓣新穿孔术（AVN）是一种新兴的主动脉瓣疾病外科治疗选择。虽然日本已经报道了优异的结果，有关其在美国使用的数据很少。
方法：所有接受AVN（AVN组）或SAVR生物瓣膜（SAVR组）的成年患者均在2015年至2022年之间进行鉴定。使用倾向评分匹配来调整两组之间的基线特征。
结果：共有101例患者接受了AVN，1,816例患者接受了生物人工瓣膜的SAVR。AVN组中没有要求转换为SAVR。匹配之前,AVN组的平均年龄为68.5±8.8岁，56例(55.4%)患者接受了伴随手术。术前,3（3%）有心内膜炎。38例（38.4%）观察到二尖瓣。在AVN组中没有人在30天死亡。中位随访时间为3.2年。PSM之后,5年至少中度主动脉瓣返流的预期生存率和自由度分别为91.7±3.1％和97.6±1.7％，分别。倾向评分匹配每组有77名患者。Kaplan-Meier曲线显示两组间5年生存率相同(P=.95)。此外,5年时至少没有中度主动脉瓣反流的情况相当(P=.23).
结论：AVN可以安全地用于各种主动脉瓣疾病，有或没有伴随手术。在美国成年人群中，与使用生物人工瓣膜的SAVR相比，AVN显示出相似的中期结果。
方法：所有接受AVN（AVN组）或SAVR生物瓣膜（SAVR组）的成年患者均在2015年至2022年之间进行鉴定。使用倾向评分匹配来调整两组之间的基线特征。
结果：共有101例患者接受了AVN，1,816例患者接受了生物人工瓣膜的SAVR。AVN组中没有要求转换为SAVR。匹配之前,AVN组的平均年龄为68.5±8.8岁，56例(55.4%)患者接受了伴随手术。术前,3（3%）有心内膜炎。38例（38.4%）观察到二尖瓣。在AVN组中没有人在30天死亡。中位随访时间为3.2年。PSM之后,5年至少中度主动脉瓣返流的预期生存率和自由度分别为91.7±3.1％和97.6±1.7％，分别。倾向评分匹配每组有77名患者。Kaplan-Meier曲线显示两组间5年生存率相同(P=.95)。此外,5年时至少没有中度主动脉瓣反流的情况相当(P=.23).
结论：AVN可以安全地用于各种主动脉瓣疾病，有或没有伴随手术。在美国成年人群中，与使用生物人工瓣膜的SAVR相比，AVN显示出相似的中期结果。
