Aortic valve neocuspidization using autologous versus bovine
pericardium: Ozaki versus Batista
Abstract
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
minimising foreign valve tissue. AV Neo can either be performed using
glutaraldehyde-treated autologous pericardium (Ozaki procedure) or
bovine pericardium (Batista procedure). Aims: 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 in order to collate
the relevant research evidence. Results: Although the Ozaki procedure
can achieve favourable 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.
Conclusion: 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.