Impact of Coronary Artery Disease on Long-Term Valve Function After the Ozaki Procedure: A Single-Center Retrospective Cohort Study (2015 - 2020).
- 1FSBI Federal Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation Penza Russian Federation FSBI Federal Center of Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Penza, Russian Federation.
Abstract
Introduction
The Ozaki procedure reconstructs the aortic valve with autologous pericardium, but long-term leaflet durability remains uncertain. Coronary artery disease (CAD) may reflect a systemic atheroinflammatory milieu associated with impaired leaflet integrity.Methods
We retrospectively studied 733 patients undergoing Ozaki reconstruction from 2015 to 2020 and assessed the association between CAD and aortic regurgitation (AR) ≥ 2 at last echocardiographic follow-up. Baseline heterogeneity was addressed using propensity-score overlap weighting based on age, sex, body mass index, body surface area, weight, diabetes, European System for Cardiac Operative Risk Evaluation II, aortic stenosis, bicuspid valve, and peripheral artery disease. Effects were estimated as weighted risk ratios (RRs) using Poisson models with robust variance. Sensitivity analyses used stabilized inverse probability of treatment weighting (IPTW) and an extended model including prior myocardial infarction/percutaneous coronary intervention.Results
Of 733 patients, 365 (49.8%) had CAD. Unadjusted AR > 2 rates were 10.1% in CAD vs. 5.7% in no-CAD patients (P = 0.037). After overlap weighting, weighted risks were 12.7% vs. 6.2%, yielding RR 2.05 (95% CI, 1.01 - 4.18; P = 0.048), with excellent covariate balance. IPTW showed consistent results: RR 2.22 (95% CI, 1.38 - 3.56; P = 0.001). Regurgitation-free survival was lower in CAD patients (log-rank P = 0.0087).Conclusion
CAD was associated with an approximately two-fold higher risk of AR ≥ 2 after Ozaki reconstruction. This association likely reflects systemic atheroinflammatory processes rather than a direct mechanical effect, supporting closer postoperative surveillance in CAD patients.
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BibTeX
@article{bazylev2026impact,
title = {{Impact of Coronary Artery Disease on Long-Term Valve Function After the Ozaki Procedure: A Single-Center Retrospective Cohort Study (2015 - 2020).}},
author = {Vladlen Bazylev and Artur Mikulyak and Khadiev M Dzhokhar and Yazan Khanfar and Vadim Karnakhin},
journal = {Brazilian journal of cardiovascular surgery},
year = {2026},
month = jul,
doi = {10.21470/1678-9741-2025-0187},
url = {https://europepmc.org/article/MED/42899560},
note = {CC BY},
}
RIS
TY - JOUR
TI - Impact of Coronary Artery Disease on Long-Term Valve Function After the Ozaki Procedure: A Single-Center Retrospective Cohort Study (2015 - 2020).
AU - Vladlen Bazylev
AU - Artur Mikulyak
AU - Khadiev M Dzhokhar
AU - Yazan Khanfar
AU - Vadim Karnakhin
PY - 2026
DA - 2026/07/01
JO - Brazilian journal of cardiovascular surgery
DO - 10.21470/1678-9741-2025-0187
UR - https://europepmc.org/article/MED/42899560
AB - Introduction The Ozaki procedure reconstructs the aortic valve with autologous pericardium, but long-term leaflet durability remains uncertain. Coronary artery disease (CAD) may reflect a systemic atheroinflammatory milieu associated with impaired leaflet integrity.Methods We retrospectively studied 733 patients undergoing Ozaki reconstruction from 2015 to 2020 and assessed the association between CAD and aortic regurgitation (AR) ≥ 2 at last echocardiographic follow-up. Baseline heterogeneity was addressed using propensity-score overlap weighting based on age, sex, body mass index, body surface area, weight, diabetes, European System for Cardiac Operative Risk Evaluation II, aortic stenosis, bicuspid valve, and peripheral artery disease. Effects were estimated as weighted risk ratios (RRs) using Poisson models with robust variance. Sensitivity analyses used stabilized inverse probability of treatment weighting (IPTW) and an extended model including prior myocardial infarction/percutaneous coronary intervention.Results Of 733 patients, 365 (49.8%) had CAD. Unadjusted AR > 2 rates were 10.1% in CAD vs. 5.7% in no-CAD patients (P = 0.037). After overlap weighting, weighted risks were 12.7% vs. 6.2%, yielding RR 2.05 (95% CI, 1.01 - 4.18; P = 0.048), with excellent covariate balance. IPTW showed consistent results: RR 2.22 (95% CI, 1.38 - 3.56; P = 0.001). Regurgitation-free survival was lower in CAD patients (log-rank P = 0.0087).Conclusion CAD was associated with an approximately two-fold higher risk of AR ≥ 2 after Ozaki reconstruction. This association likely reflects systemic atheroinflammatory processes rather than a direct mechanical effect, supporting closer postoperative surveillance in CAD patients.
SN - 0102-7638
SN - 1678-9741
ER -