First patients benefit from pioneering treatment for aortic valve disease
RB&HH experts hope new Ozaki procedure could revolutionise the way surgery is carried out in the UK for patients with the life-threatening condition.
As one of the country’s largest and most experienced centres for the diagnosis and treatment of heart valve disease, Royal Brompton Hospital (RBH) has a long history of pioneering medical innovations that have increased treatment options and improved the lives of patients with the condition.
The groundbreaking Ozaki procedure is the latest cutting-edge technique to be implemented at RBH to benefit patients who require aortic valve surgery. It is the first time that surgeons in the UK have been able to use heart tissue from an animal to reconstruct a damaged aortic valve, instead of replacing it entirely with a prosthetic implant.
The aortic valve controls the flow of blood from the heart to the rest of the body. When its function is impaired, for example, through aortic stenosis (narrowing of the valve), aortic valve regurgitation (a leaking valve), or because of a congenital heart defect, surgery is usually required to replace it and restore normal function. If left untreated, a poorly-performing aortic valve can seriously reduce a patient’s quality of life and eventually lead to heart failure and death.
Surgeons carrying out conventional aortic valve replacements commonly use a mechanical implant made from synthetic materials, which requires the patient to take lifelong anticoagulant drug therapy to protect against harmful blood clots. Patients can, however, experience side effects and taking the medication indefinitely has lifestyle limitations. Alternatively, biological implants made from animal tissue do not require blood-thinning drug therapies (typically warfarin in the UK), but they degenerate and usually need to be surgically replaced after around eight to 15 years, depending on the patient’s age (degeneration occurs more quickly in those under 60), or even more frequently for children who outgrow their valve.
Data from Japan, where the Ozaki procedure originated ten years ago, shows the new technique, now being adopted by surgeons at RBH, is longer lasting than replacing the valve entirely. The heart tissue used to repair the valve is specially treated in a laboratory to ensure it does not degenerate and to eliminate the risk of rejection by the body’s immune system. The surgical team at RBH believes the new procedure also has advantages over the complex ‘Ross’ procedure, which is a more invasive operation that involves replacing the diseased aortic valve with the patient’s pulmonary valve, and replacing their pulmonary valve with a valve from a deceased donor.
Under the guidance of consultant cardiac surgeon, Mr Cesare Quarto, the team at RBH carried out the first adult Ozaki procedure in the country in 2016 and is the UK’s only unit that is able to provide the treatment to adult patients. Meanwhile, paediatric cardiac surgeon, Mr Olivier Ghez, who performed the very first Ozaki procedure at RBH, offers the treatment to children and young adults as an alternative to valve replacement surgery.
Mr Quarto said: “This is an exciting development for patients in need of aortic valve surgery. Experts in Japan have followed hundreds of patients who had this procedure almost ten years ago. The evidence shows it can be a longer term solution than the alternative options due to its more natural physiology.
“As a specialist centre for patients with congenital heart disease and acquired cardiac problems, we are always striving to provide patients with the very best and most advanced treatment options. Our early results for patients who have undergone this new procedure at Royal Brompton are extremely encouraging and we hope many more patients will benefit from this novel technique in the future.”
Mr Olivier Ghez added: “The main advantage of this procedure for younger patients is that it delays any further problems with their aortic valve and allows them to lead an active life, without needing to take ongoing medication to prevent blood clots.”
Mr Olivier Ghez
Consultant in Paediatric and Congenital Heart Surgery
Specialises in neonatal heart surgery, congenital heart diseases and circulatory assistance
Mr Cesare Quarto
Consultant Cardiac Surgeon
Specialist in cardiac surgery with experience in all areas of cardiac surgery, including some of the most complex aortic surgery
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