International journal of surgery (London, England) · 2025
Ozaki technique versus Ross operation for complex aortic valve diseases in children: a retrospective cohort study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Wang Guan-Xi, Zhang Sen, Ma Kai, Pang Kun-Jing, Wang Xu, Yang Ke-Ming, Zhang Ben-Qing, Yang Yang, Li Shou-Jun
Аннотация
BACKGROUND: The Ozaki technique demonstrated promising results in adults, but few studies reported on pediatric patients with limited follow-up time. This study aimed to evaluate the mid-term results of Ozaki technique compared with Ross operation for complex aortic valve diseases in children.
MATERIALS AND METHODS: One hundred and seventeen children underwent either Ozaki ( n =64) or Ross ( n =53) operation from January 2017 to December 2023. The primary endpoint was incidence of moderate or severe regurgitation/stenosis (AR/AS) post procedure.
RESULTS: No significant difference was observed in age (6.5±3.4 vs. 7.9±4.3 years) and weight (25.9±15.5 vs. 31.0±25.9 kgs) at surgery. The Ozaki group had significantly more patients in heart failure (20.3 vs. 1.9%, P = 0.003) before surgery and more patients needed ECMO installation (6.3% vs. 0, P =0.125) after surgery. The Ozaki group were in worse status with more patients occurred heart failure (20.3 vs. 1.9%, P = 0.003) before surgery and needed ECMO installation (6.3 vs. 0, P = 0.125) after surgery. During follow-up (20.4±17.3 vs. 22.7±22.8 months, P =0.526), five patients (7.8%) in Ozaki group but no patients in Ross group required reoperations. The incidence of moderate or severe AR (28.1 vs. 3.1%) and AS (31.3 vs. 5.7%) were significantly higher than Ross group. Multivariate analysis identified lower age [HR: 1.282 (95% CI: 1.075-1.529), P =0.006] and ECMO installation [HR: 0.126 (0.018-0.887), P =0.037] to be risk factors for moderate or severe AR, and higher aortic transvalvular gradient before discharge was confirmed as the only risk factor for moderate or severe AS (≥36 mmHg) at follow-up in Ozaki group.
CONCLUSION: Ozaki technique may be used as a palliative procedure for complex aortic valve diseases in children, but its' mid-term results were not durable as Ross surgery, especially younger patients.
MATERIALS AND METHODS: One hundred and seventeen children underwent either Ozaki ( n =64) or Ross ( n =53) operation from January 2017 to December 2023. The primary endpoint was incidence of moderate or severe regurgitation/stenosis (AR/AS) post procedure.
RESULTS: No significant difference was observed in age (6.5±3.4 vs. 7.9±4.3 years) and weight (25.9±15.5 vs. 31.0±25.9 kgs) at surgery. The Ozaki group had significantly more patients in heart failure (20.3 vs. 1.9%, P = 0.003) before surgery and more patients needed ECMO installation (6.3% vs. 0, P =0.125) after surgery. The Ozaki group were in worse status with more patients occurred heart failure (20.3 vs. 1.9%, P = 0.003) before surgery and needed ECMO installation (6.3 vs. 0, P = 0.125) after surgery. During follow-up (20.4±17.3 vs. 22.7±22.8 months, P =0.526), five patients (7.8%) in Ozaki group but no patients in Ross group required reoperations. The incidence of moderate or severe AR (28.1 vs. 3.1%) and AS (31.3 vs. 5.7%) were significantly higher than Ross group. Multivariate analysis identified lower age [HR: 1.282 (95% CI: 1.075-1.529), P =0.006] and ECMO installation [HR: 0.126 (0.018-0.887), P =0.037] to be risk factors for moderate or severe AR, and higher aortic transvalvular gradient before discharge was confirmed as the only risk factor for moderate or severe AS (≥36 mmHg) at follow-up in Ozaki group.
CONCLUSION: Ozaki technique may be used as a palliative procedure for complex aortic valve diseases in children, but its' mid-term results were not durable as Ross surgery, especially younger patients.