Ozaki Procedure for the treatment of Aortic Valve Endocarditis : A
Life-saving Alternative
Abstract
Infective endocarditis (IE) still has a high risk of mortality and
morbidity, despite of developments in medical treatment. Intracranial
hemorrhage is one of serious complication, which has poor outcome. We
present a 30-year-old male with diagnosis of IE. He had severe aortic
regurgitation and oscillating vegetations on both side of the aortic
valve. Although there was no neurological symptom in preoperative
period, cranial magnetic resonance imaging (MRI) revealed millimetric
size ischemic lesions at the right cerebral hemisphere. We performed
Ozaki procedure. However, cerebral hemorrhage occurred on the first
postoperative day. Computerized tomography (CT) revealed hematoma in
parietal and occipital lobes. He was treated with conservative
anti-edema therapy and discharged from the hospital on the 25th day with
minor visual defect of his eye. Echocardiography control revealed mild
aortic regurgitation without any other pathologic finding after 18
months. Aortic neocuspidization by using using of glutaraldehyde treated
autologous pericardium decreases the risk of fibrosis and calcification,
and thrombosis events. Possibility of suspending the anticoagulant and
antiplatelet regimen is a significant advantage in this type of repair.
Ozaki procedure might be the first-choice surgical reconstruction
technique in anatomically suitable IE cases.