Immediate outcomes of open transaortic implantation of balloon-expandable prosthesis with synthetic leaflets compared to Ozaki procedure

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Abstract
Objective. To compare clinical and hemodynamic outcomes of open transaortic implantation of balloon-expandable prosthesis with PTFE leaflets and Ozaki procedure (AV-Neo). Material and methods. A prospective study included 101 patients who underwent open transaortic aortic valve replacement with balloon-expandable prosthesis with polytetrafluoroethylene leaflets and 277 patients who underwent AV-Neo procedure. The primary endpoint was in-hospital mortality. Results. Significant differences were found in the incidence of blood transfusions (p=0.02), acute kidney injury (AKI) (p=0.018), and total number of complications (in-hospital mortality+myocardial infarction+AKI) (p=0.006). Significant differences were also found in characteristics of surgical interventions: duration of cardiopulmonary bypass (CPB) (p=0.02), aortic cross-clamping (p=0.002), and surgery (p=0.03). Conclusion. Transaortic implantation of balloon-expandable graft has a significant advantage over Ozaki procedure. Comparison of perioperative parameters (time of surgery, CPB and aortic cross-clamping) revealed significant differences in favor of transaortic implantation (p=0.03; 0.002; 0.03), as well as lower risk of in-hospital mortality.

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