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The aortic valve separates the left ventricle (lower left chamber) of the heart from the aorta, which carries blood to the rest of the body.

When working properly, the aortic valve is a one-way gate. It opens to let blood from the left ventricle flow into the aorta when the heart pumps. Between heartbeats, the valve closes to keep blood from flowing backward into the ventricle.

If the aortic valve isn’t working properly, it affects the heart’s overall function. This condition is known as aortic valve disease. Types of aortic valve disease include:

  • Aortic stenosis: When the valve doesn’t open wide enough to allow adequate blood flow.
  • Aortic valve regurgitation: When the valve doesn’t close properly, causing blood to leak backward into the heart.
  • Bicuspid aortic valve: A birth defect in which the valve may not close correctly, causing blood to flow backward into the heart.
  • Endocarditis: An aortic valve infection.

The Ozaki procedure is an innovative treatment for aortic valve disease.

What Is the Ozaki Procedure?

A common treatment for aortic valve disease is aortic valve replacement (AVR). In traditional AVR surgery, doctors remove the diseased valve and replace it with a synthetic mechanical valve or a valve made of animal tissue.

The Ozaki procedure replaces a diseased valve with one constructed from your own tissue. Doctors use part of the pericardium — the sac surrounding your heart — to create the new valve.

“The attractive nature of this procedure is the surgeon is able to reconstruct a diseased aortic valve with your own tissue,” says Danny Chu, MD, senior staff cardiac surgeon, UPMC Heart and Vascular Institute.

Experts at UPMC Heart and Vascular Institute have several years of clinical experience with the Ozaki procedure. They train surgeons from across the world to use this innovative technique.

How Does the Ozaki Procedure Work?

Most patients with aortic valve disease are candidates for the Ozaki procedure. The exception is people who have undergone heart surgery in the past. That’s because doctors typically cut through the pericardium to perform heart surgery.

Before the procedure, doctors take a non-contrast CT scan of the chest. They look at the size of the heart and blood vessels and the quality of the pericardium.

For the operation, the surgeon makes an incision in the chest and separates the breastbone. The surgeon removes a piece of the patient’s pericardium, places the patient on a heart-lung machine, and removes the diseased aortic valve.

After adding a chemical called glutaraldehyde to the pericardium tissue to strengthen it, the surgical team constructs a new valve.

A normal aortic valve has three tissue flaps (leaflets) that open and close to control blood flow. During the Ozaki procedure, the surgeon uses stitches to create the three leaflets for the new valve.

After creating the new valve, the surgeon places it into the patient’s heart and finishes the procedure. The procedure can take several hours.

Patients usually stay in the hospital for five to seven days afterward and have one to two months of recovery, Dr. Chu says.

“We’ll see the patient in clinic about a month or so after the operation,” Dr. Chu says. “We’ll get an ultrasound to look at the valve. After that, we’ll want the patient to get an ultrasound once a year to look at this valve.”

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Benefits of the Ozaki Procedure

More than 10 years of data on the Ozaki procedure show no major long-term complications from the treatment.

Dr. Chu says data show that 95% of patients won’t need another operation. And patients who have the Ozaki procedure are at nearly zero risk of needing a permanent pacemaker. That data comes from a study in the Journal of Thoracic and Cardiovascular Surgery.

Dr. Chu stresses that the Ozaki procedure is not experimental. It is approved by the U.S. Food and Drug Administration and has been a beneficial alternative for many UPMC patients.

Other benefits of the Ozaki technique include:

  • No risk of your body rejecting the valve since it’s made from your own heart tissue.
  • No long-term blood thinners are required.
  • The valves have good blood flow dynamics.

Risks of the Ozaki Procedure

Risks of the Ozaki procedure are similar to other valve replacements, including:

  • Bleeding
  • Blood clots
  • Infection
  • Irregular heart rhythms

The Ozaki Procedure at UPMC

UPMC is the only health care provider in western Pennsylvania to offer the Ozaki procedure. The team of experts at UPMC’s Center for Heart Valve Disease has the highest volume of adult Ozaki procedures in the United States. Led by Dr. Chu, the center is a UPMC Center of Excellence.

Dr. Chu hopes the Ozaki procedure becomes a more standard approach for valve replacement.

“The data speaks for itself,” Dr. Chu says. “The data for this is better than nearly all the tissue valves out there. This should be a really attractive option for many patients.”

The UPMC Heart and Vascular Institute offers world-class care close to home. We offer a team approach to care and cutting-edge treatments.

For more information on the UPMC Heart and Vascular Institute:

Sources

American Heart Association, Roles of Your Four Heart Valves. Link

American Heart Association, Heart Valve Problems and Causes. Link

AVNeo, Understand AVNeo. Link

AVNeo, Benefits of AVNeo. Link

Shigeyuki Ozaki, MD, et al, The Journal of Thoracic and Cardiovascular Surgery, Midterm Outcomes After Aortic Valve Neocuspidization With Glutaraldehyde-treated Autologous Pericardium. Link

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.