Aortic valve diseases, which can be congenital or acquired, both reduce the quality of life and have the potential for reaching stages in which they are life-threatening. Therefore, when an individual manifests symptoms such as becoming easily exhausted, shortness of breath, fainting spells and chest pain with the heart being adversely affected by these problems, surgery comes to the fore. However, the mechanical valves that are used for treatment require patients to use anticoagulants all through their lives after the operation. Biological valves, on the other hand can require a second operation due to degeneration in time. The world of medicine took notice of these problems and developed the “Ozaki” method as an alternative to the mechanical and biological valves that have been in use until now. This method, which has been practiced for 9 years around the world and one year in our country, involves use of a valve made from the cardiac membrane of the patient instead of a prosthetic valve. Professor Cem Alhan, a cardiovascular surgeon at Acıbadem Maslak Hospital, stated that the Ozaki method is a promising development for many patients and said, “Until now, we have always used mechanical or biological prosthetics for patients with aortic valve conditions. With this method, we are able to perform valve surgery on patients without having to use any foreign materials at all. One of the greatest benefits of this method is particularly its capability to raise the quality of life for patients by eliminating the need to use anticoagulants after the operation”.
The aortic valve serves as a kind of throttle by preventing the blood pumped by the heart from returning to the heart. However it is possible for individuals to suffer from aortic valve stenosis or aortic insufficiency due to congenital anomalies, certain diseases a person may go through or aging. As a result, the functioning of the heart becomes disrupted. Since this can lead to life-threatening conditions in time, it is required for the valve to be replaced. As a cardiovascular surgeon, Professor Cem Alhan states that the preference in treatment of aortic valve diseases is to repair the valve and says, “If this is not possible, then the valve is replaced”. The standard method that has been in use until now for such operations is replacement of the valve with biological or mechanical prosthetics. In the Ozaki method, however, a valve with dimensions that are in line with the anatomy of the patient’s own aortic valve is made from the patient’s cardiac membrane during surgery. The produced valve is then sutured all around and thoroughly joined with the aorta. Professor Cem Alhan states that the Ozaki method can be applied on all patients who require aortic valve replacement, with a few exceptions.
While mechanical heart valves are very sturdy, it is possible for them to cause complications due to blood coagulation. Therefore, use of anticoagulants becomes necessary for life after aortic valve surgery. Furthermore, it is necessary for the dosage of the medications to be adjusted through blood tests every 3 weeks. This is because a dosage that is too low leads to clots that cause valve problems and a dosage that is too high leads to hemorrhages. Since the aortic valve in the Ozaki method is made from the patient’s own cardiac membrane, there is no need for treatment with anticoagulants. Therefore, the patient is saved from both periodical blood tests and the potential complications of anticoagulants.
One of the most important advantages of the Ozaki method is the fact that it reduces the risk for requiring a second operation in children who undergo aortic valve surgery. The heart of a child becomes larger in parallel to the growth of the child. This can cause for the aorta to outgrow the prosthetic valve and lead to requirement for a second operation. The valve that is made from the child’s own tissue, on the other hand, eliminates the risk of needing surgery every 3 to 5 years. It is also possible for the biological valves in adults to degenerate in time and lead to the need for a second operation. According to the results of the first published studies on the Ozaki method, the risk of degeneration is very low in this new technique.
An important advantage for expecting mothers Use of anticoagulants during pregnancy can lead to serious anomalies in the baby. Since the Ozaki method involves no such drugs, these complications are avoided.
Prosthetic valves are sutured to the aorta with sewing rings. Since these rings restrict the valve space, the amount of blood that flow through the aorta is reduced. As a result, the heart exerts more effort to supply the blood needed by the body and eventually becomes exhausted. Professor Cem Alhan states that since the Ozaki method does not require sewing rings and involves suturing the two tissues together like pieces of fabric, there are no restriction problems in the aorta and the heart is saved from extra effort.
The sewing ring in prosthetic valves can cause tension and lead to conduction issues in the heart. As a cardiovascular surgeon, Professor Cem Alhan states that arrhythmia, which can develop afterwards, can lead to the requirement for inserting a permanent pacemaker in the patient’s body and says, “The Ozaki method, however, does not utilize any foreign materials that can damage tissues; this prevents arrhythmia and eliminates the need for a pacemaker”.
It is usually necessary for cardiac valves to be replaced every 10 to 15 years. Professor Cem Alhan states that since the method makes use of the patient’s own cardiac membrane, the valves are expected to last longer than biological ones.