{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:44:04Z","timestamp":1792165444931,"version":"4.4.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,17]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">We assessed the Ozaki procedure, aortic valve reconstruction using autologous pericardium, with respect to its learning curve, hemodynamic performance, and durability compared with a stented bioprosthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      From January 2007 to January 2016, 776 patients underwent an Ozaki procedure at Toho University Ohashi Medical Center. Learning curves, aortic regurgitation (AR), and peak gradient, assessed by serial echocardiograms, valve rereplacement, and survival were investigated. Valve performance and durability were compared with 627 1:1 propensity\u2010matched patients receiving stented bovine pericardial valves implanted from 1982 to 2011 at Cleveland Clinic. Learning curves were observed for aortic clamp and cardiopulmonary bypass times, AR prevalence, and early mortality. Decreased aortic clamp time was observed over the first 300 cases. New surgeons performing parts of the procedure after case 400 resulted in a slight increase in aortic clamp and cardiopulmonary bypass times. Among matched patients, the Ozaki cohort had more AR than the PERIMOUNT cohort (severe AR at 1 and 6\u2009years, 0.58% and 3.6% versus 0.45% and 1.0%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      [trend]=0.006), although with a steep learning curve. Peak gradient showed the opposite trend: 14 and 17\u2009mm\u2009Hg for Ozaki and 24 and 28\u00a0mm\u2009Hg for PERIMOUNT at these times (\n                      <jats:italic>P<\/jats:italic>\n                      [trend]\n                      <jats:italic>&lt;<\/jats:italic>\n                      0.001). Freedom from rereplacement was similar (\n                      <jats:italic>P<\/jats:italic>\n                      =0.491). Survival of the Ozaki cohort was 85% at 6\u00a0years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients undergoing the Ozaki procedure had lower gradients but more recurrent AR than those receiving PERIMOUNT bioprostheses. Although recurrent AR is concerning, results confirm low risk and good midterm performance of the Ozaki procedure, supporting its continued use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.027391","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T05:05:40Z","timestamp":1673413540000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Aortic Valve Reconstruction With Autologous Pericardium Versus a Bioprosthesis: The Ozaki Procedure in\u00a0Perspective"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-073X","authenticated-orcid":false,"given":"Shinya","family":"Unai","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular, and Thoracic Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4616-9779","authenticated-orcid":false,"given":"Shigeyuki","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas R.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular, and Thoracic Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-4279","authenticated-orcid":false,"given":"Tomohiro","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeevanantham","family":"Rajeswaran","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Lerner Research Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5749-4588","authenticated-orcid":false,"given":"Lars G.","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular, and Thoracic Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9839-3567","authenticated-orcid":false,"given":"Eugene H.","family":"Blackstone","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular, and Thoracic Institute Cleveland Clinic Cleveland OH"},{"name":"Department of Quantitative Health Sciences Lerner Research Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00f6sta B.","family":"Pettersson","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery Heart, Vascular, and Thoracic Institute Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)33497-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.1991.tb00351.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.04.041"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.09.038"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02992-7"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2010.253682"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.01.087"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.10.070"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0962280214537255"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0962280215623583"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1986.10478314"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0962280212445945"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3150"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/pst.433"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.03.017"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2018.14591"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/IMI.0000000000000556"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-018-0976-0"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.04.108"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0218492320981468"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.045"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy190"},{"key":"e_1_3_2_24_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.21688\/1681-3472-2016-3-26-30","article-title":"Immediate results of aortic valve reconstruction by using autologous pericardium (Ozaki procedure)","volume":"20","author":"Rosseykin EV","year":"2016","unstructured":"Rosseykin EV, Bazylev VV, Batrakov PA, Karnakhin VA, Rastorguev AA. Immediate results of aortic valve reconstruction by using autologous pericardium (Ozaki procedure). Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2016;20:26\u201330. (In Russ.).","journal-title":"Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0218492314520748"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14377"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.03.006"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)01110-2"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.06.039"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytz105"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2019.03.035"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2019.05.12"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-13-1068"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-005-0088-5"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.07.040"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezv432"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.122.027391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T08:39:54Z","timestamp":1715589594000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.122.027391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,17]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,1,17]]}},"alternative-id":["10.1161\/JAHA.122.027391"],"URL":"https:\/\/doi.org\/10.1161\/jaha.122.027391","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,17]]},"assertion":[{"value":"2022-07-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e027391"}}