背景:人口的平均生存年龄在不断增加,主动脉瓣疾病的发病率和患病率也在不断增加。外科主动脉瓣置换术(SAVR)是目前治疗的金标准。然而,SAVR中人工瓣膜的使用与影响患者生活质量的问题相关.主动脉瓣新穿孔(AVNeo)提供了一种通过最大程度地减少外来瓣膜组织来解决这一难题的方法。AVNeo可以使用戊二醛处理的自体心包(Ozaki程序)或牛心包(Batista程序)进行。
目的:这篇评论旨在讨论Chan及其同事最近的一项研究,该研究强调了手术方法,临床结果,以及Ozaki程序的局限性,并将其与Batista手术进行比较。
方法:使用包括PubMed在内的多个电子数据库进行了全面的文献检索,奥维德,Embase,和Scopus整理相关研究证据。
结果:尽管Ozaki手术可以取得良好的效果,同时主要避免了使用机械瓣膜进行终身口服抗凝治疗的需要,它仍然有一些限制,可能会阻碍结果。AVNeo使用戊二醛处理的牛心包,由先驱心脏外科医生RandasJ.VilelaBatista博士开发,产生优于Ozaki的临床结果,包括优秀的生存,并发症较低,和最小的需要再次手术以及较短的手术时间。
结论:AVNeo提供了一种在逃避人工瓣膜问题的同时进行SAVR的方法。然而,Batista手术毫无疑问地表明,它可以被认为是AVNeo优于Ozaki手术的方法。
BACKGROUND: The average living age of the population is constantly increasing and so is the incidence and prevalence of aortic valve disease. Surgical aortic valve replacement (SAVR) is the current gold standard treatment. Nevertheless, the use of prosthetic valves in SAVR is associated with issues that impact patients\' quality of life. Aortic valve
neocuspidization (AV Neo) offers a means to solve this dilemma by minimizing foreign valve tissue. AV Neo can either be performed using glutaraldehyde-treated autologous pericardium (Ozaki procedure) or bovine pericardium (Batista procedure).
OBJECTIVE: This commentary aims to discuss the recent study by Chan and colleagues which highlighted the surgical approach, clinical outcomes, and limitations of the Ozaki procedure, and compare this to the Batista procedure.
METHODS: A comprehensive literature search was performed using multiple electronic databases including PubMed, Ovid, Embase, and Scopus to collate the relevant research evidence.
RESULTS: Although the Ozaki procedure can achieve favorable results whilst mainly avoiding the need for life-long oral anticoagulation with mechanical valves, it still has several limitations that may hinder results. AV Neo using glutaraldehyde-treated bovine pericardium, developed by pioneer cardiac surgeon Dr. Randas J. Vilela Batista, yields superior clinical outcomes to Ozaki\'s, including excellent survival, lower complications, and minimal need for reoperation as well as shorter operative times.
CONCLUSIONS: AV Neo offers a means to perform SAVR whilst escaping the prosthetic valve issues. However, the Batista procedure has shown beyond doubt that it can be considered the superior approach for AV Neo over the Ozaki procedure.