الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The concept of the ideal cardiac valve prosthesis is predicated upon optimized hemodynamics, minimal postoperative morbidity, lasting durability, and ultimately prolonged patient survival with superior quality of life. Mechanical valves require lifelong anticoagulation and therefore predispose to hemorrhagic events. On the other hand, biological prostheses mount a chronic inflammatory response, are prone to structural degeneration, and typically require a reintervention within 10 to 15 years. Efforts to replace aortic valve (AV) tissue with biological material such as fascia lata and pericardium date back to the 1960s. Ozaki developed their AV reconstruction technique at Toho University Ohashi Medical Center where they standardized the use of glutaraldehyde-treated autologous pericardium to perform trileaflet aortic valve. Therefore, it achieves maximum effective orifice area (EOA) and low transvalvular gradients. Lastly, long-term coumadin anticoagulation is not required. Although repair approaches are limited to regurgitant valves, the Ozaki procedure can be used to treat a wide spectrum of AV pathology including aortic stenosis, infective endocarditis, and prosthetic valve endocarditis. A total of 86 patients were enrolled in the current study; group A included 43 patients who were undergone AVR using a biological aortic valve prosthesis and group B included 43 patients who were undergone AVR using the Ozaki procedure. The current study aimed to perform hemodynamic analyses CMR in patients with aortic valve replacement (AVR) using the Ozaki procedure. In particular, we aimed to compare the hemodynamic performance of the Ozaki leaflet reconstruction vs standard biological AVR. Both groups had comparable findings either baseline, perioperative data or during follow up. During follow up either at 3rd or 6th month both groups had insignificant differences. Renal dysfunction was reported in 5 (11.6%) patients of biological valve group and two patients of Ozaki group. Endocarditis was developed in only two patients with biological valve. Mild aortic regurge was noticed in one patient at 3rd month and two patients at 6th month in case of Ozaki procedure while only one patient in biological valve group developed mild AR at 6th month of follow up. Nearly all patients had improved NYHA class in both groups. None patient in Ozaki group was converted to AVR In conclusion, we have described our initial experience with the Ozaki procedure in adults. The current study reported promising results for Ozaki procedure. Yet, multiple future studies in multiple centers are warranted to draw firm conclusion and support our findings