{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:42:30Z","timestamp":1762868550874,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T00:00:00Z","timestamp":1624406400000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rheumatic valve disease (RVD) is the most common cause of cardiovascular death in low-middle income nations. Surgical aortic valve (AV) interventions for RVD, especially in children, have proven problematic with graft failure, relapse, and poor compliance with anticoagulation. A novel technique involving neocuspidization of the aortic annulus using autologous pericardium to construct new AV leaflets (the Ozaki procedure) has shown promising outcomes in children with congenital AV disease; however, there are no previous recorded cases using this technique in children with RVD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present the case of a 15-year-old male presenting with exertional angina and dyspnoea with a background of previous rheumatic fever. Echocardiography had shown a regurgitant tricuspid AV, left ventricular dilatation with mitral valve leaflet tethering. The patient underwent the Ozaki procedure for his AV regurgitation and was discharged following an uneventful post-operative recovery. The patient had full resolution of symptoms following the procedure and remains well 3\u2009years following his operation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>This case highlights that good outcomes with the Ozaki procedure in RVD are possible 3-years post-operatively and should prompt future studies to evaluate the procedure as a surgical option for paediatric patients in this clinical context. Additionally, the Ozaki procedure may also provide a cost-effective surgical technique requiring minimal additional operative resources and reduced follow-up demand, which would be critical in low-resource clinical settings where RVD is prevalent.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab170","type":"journal-article","created":{"date-parts":[[2021,6,23]],"date-time":"2021-06-23T07:18:55Z","timestamp":1624432735000},"source":"Crossref","is-referenced-by-count":2,"title":["Management of rheumatic aortic valve disease using the Ozaki procedure with autologous pericardium: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-1083","authenticated-orcid":false,"given":"Ashar","family":"Asif","sequence":"first","affiliation":[{"name":"University of Bristol, Medical School, Senate House, Tyndall Ave, Bristol BS8 1TH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7074-7949","authenticated-orcid":false,"given":"Umberto","family":"Benedetto","sequence":"additional","affiliation":[{"name":"University of Bristol, Medical School, Senate House, Tyndall Ave, Bristol BS8 1TH, UK"},{"name":"Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Terrell St, Bristol, BS2 8ED, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1901-5619","authenticated-orcid":false,"given":"Victor","family":"Ofoe","sequence":"additional","affiliation":[{"name":"Children's Heart Unit for Wales, University Hospital of Wales, Heath Park Way, Cardiff, CF14 4XW, U K"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7508-0891","authenticated-orcid":false,"given":"Massimo","family":"Caputo","sequence":"additional","affiliation":[{"name":"University of Bristol, Medical School, Senate House, Tyndall Ave, Bristol BS8 1TH, UK"},{"name":"Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Terrell St, Bristol, BS2 8ED, UK"},{"name":"Bristol Children\u2019s Hospital, Upper Maudlin St, Bristol, BS2 8BJ, U K"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,23]]},"reference":[{"key":"2021070817005179500_ytab170-B1","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/S0140-6736(11)61171-9","article-title":"Rheumatic heart disease","volume":"379","author":"Marijon","year":"2012","journal-title":"Lancet"},{"key":"2021070817005179500_ytab170-B2","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1016\/j.jtcvs.2019.09.176","article-title":"The utility of aortic valve leaflet reconstruction techniques in children and young adults","volume":"159","author":"Wiggins","year":"2020","journal-title":"J Thorac Cardiovasc 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adults","volume":"67","author":"Sharabiani","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2021070817005179500_ytab170-B9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1161\/CIRCULATIONAHA.114.009835","article-title":"Accelerated degeneration of a bovine pericardial bioprosthetic aortic valve in children and young adults","volume":"130","author":"Saleeb","year":"2014","journal-title":"Circulation"},{"key":"2021070817005179500_ytab170-B10","doi-asserted-by":"crossref","first-page":"383","DOI":"10.21037\/acs.2019.05.01","article-title":"Rheumatic aortic valve disease\u2014when and who to repair?","volume":"8","author":"Afifi","year":"2019","journal-title":"Ann Cardiothorac Surg"},{"key":"2021070817005179500_ytab170-B11","article-title":"Clinical and economic burden of rheumatic heart disease in low-income nations: estimating the cost-of-illness in India and 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