LONG-TERM RESULTS OF AORTIC VALVE REPLACEMENT WITH A BIOLOGICAL PROSTHESIS AND AUTOPERICARDIUM ACCORDING TO THE OZAKI TECHNIQUE IN PATIENTS WITH SEVERE AORTIC STENOSIS WITH LOW FLOW AND LOW TRANSAORTIC PRESSURE GRADIENTS WITH REDUCED EJECTION FRACTIONS

Bazylev Vladlen Vladlenovich, Babukov Ruslan Medarisovich, Karnakhin Vadim Alexandrovich, Bartosh Fedor Leonidovich, Levina Alena Vitalievna

Objective: Evaluate long-term results in patients with low-flow aortic stenosis and low transaortic pressure gradients with decreased LV ejection fraction (ACLFLG) after autopericardial aortic valve (AV) replacement using the Ozaki technique and AV replacement with a biological prosthesis. Materials and methods. From the database, we identified all patients eligible for severe symptomatic LFLG aortic stenosis with reduced LV ejection fraction who underwent either autopericardial AV replacement (October 2015 to December 2020) or bioprosthesis AV replacement (October 2015). to December 2020). The study included all patients meeting the echocardiographic criteria for AS LFLG: mean transaortic gradient ˂ 40 mmHg. and maximum aortic flow velocity ˂ 4 m/s, ejection fraction less than 50%, stroke volume index less than 35 ml/m². The studied patients were divided into two groups: group 1, 64 patients with a biological prosthesis (mean age 65±5 years), group 2, 60 patients after autopericardial valve reconstruction using the Ozaki technique (mean age 64±7 years). All patients underwent a comprehensive transthoracic and transesophageal echocardiographic study in accordance with established modern guidelines. Results. At the hospital stage, 29 (46%) cases of moderate patient-prosthetic discrepancy (PPN) were identified in the group after prosthetics with a biological prosthesis; in the group after prosthetics with an autopericardium, no cases of PPI were detected. In the follow-up period, there was no significant difference in the number of fatal events from all causes, groups of biological valve replacement and autopericardium replacement (37% vs. 27% P=0.3), (HR 92 CI 0.7-1.3)

Keywords:aortic valve, autopericardium, Ozaki procedure