Modified Aortic Valve Neocuspidization (Ozaki AVNeo) Procedure

Abstract

There is a substantial need for interventions to replace or repair diseased aortic valves. As an alternative to conventional replacement with prostheses, we illustrate a modified technique of aortic valve neocuspidization (AVNeo).The procedure includes harvesting of autologous pericardium and cutting it into shapes analogous to the patient's aortic valve cusps to create neocusps. The native cusps are then resected and replaced with the neocusps. We highlight details of how to create, size, and attach the autologous cusps to ensure efficacy and durability.The AVNeo technique offers abundant advantages to standard aortic valve treatments. The technique is versatile and can be applied in the treatment of essentially all underlying aortic valve pathologies, whether congenital, rheumatic, degenerative, or infectious in etiology. AVNeo appears to be suitable in the growing annuli of children. The technique avoids foreign material and its drawbacks, like stiffness of the annulus and the need for anticoagulation. Though it leads to superior hemodynamic performance and low intervention rates in the short and medium term, long term durability has yet to be proven.