Ozaki Procedure

The Ozaki procedure offers an innovative, effective way to repair a diseased aortic valve by using the patient’s own tissue. This repaired valve looks and functions like a natural valve, unlike a mechanical valve or one made from animal tissue. This improves blood flow and means that patients don’t need to take the blood thinners that go along with artificial valves. 

Overlake is the only place west of the Mississippi where the groundbreaking Ozaki procedure is being done in adults.  

What is the Ozaki procedure?

Japanese heart surgeon Dr. Shigeyuki Ozaki developed this procedure in the early 2000s. It is also called the Ozaki aortic valve reconstruction. It can be used if an aortic valve has narrowed (stenosis) or is leaky (regurgitation).

During the procedure, the surgeon uses the covering around the heart (pericardium) to create a new, customized aortic valve. This new valve is based on precise measurements of the patient’s existing valve. This enables the new valve to function similar to how the original valve functioned when it was healthy.

Overlake surgeon Robert Binford, MD trained directly with Dr. Ozaki to learn how to perform this procedure. This gives our team the expertise to use this technique to help many patients live healthier lives, without some of the risks and side effects of artificial valves.

What are the benefits of the Ozaki procedure?

The Ozaki procedure’s benefits include:

• The replacement valve is made from the patient’s own tissue, rather than using a mechanical valve or a valve made from animal tissue.
• Because the valve is made from a patient’s own tissue, it functions better than an artificial valve.
• Patients do not need to take blood thinners for the rest of their life. That’s because blood does not stick to the valve or flow in ways that cause clots, which can happen with artificial valves.
• Evidence from Japan shows that 90% of repaired Ozaki valves function well for at least 12 years and possibly much longer.

What are the risks of the Ozaki procedure?

The risks are the same as with conventional valve surgery, including:

• Bleeding.
• Infections.
• Arrhythmias (abnormal heart rhythms).
• Leaking or failure of the valve.

At Overlake, our extensive experience with the Ozaki procedure and other valve surgeries enables us to keep these risks to a minimum.

What to expect with the Ozaki procedure

What to expect before the Ozaki procedure: A week before the procedure, a patient has a surgical “pre-op” visit to learn more about the procedure and discuss any questions or concerns. They are given a consent form to sign, and they may have X-rays, blood tests, and other imaging and lab work. An advanced practice provider (usually a nurse practitioner or physician assistant) will describe what to expect on the day of surgery. We also teach patients about what to expect from anesthesia and take time to answer any questions. This entire pre-op visit takes about two hours. 

What to expect during the Ozaki procedure: On the day of surgery, a patient is admitted and waits in the preoperative area until it is time for the surgery. They undergo general anesthesia. The Ozaki procedure usually takes about three to four hours. 

What to expect after the Ozaki procedure: After surgery, recovery is about the same as with other types of heart surgery. You’re first taken to the ICU, where they usually spend one or two days. You then go to a private room on the postoperative floor, where your heart rhythm is monitored continuously to be sure the new valve is working correctly.

Full recovery can take two to three months. During the first week, because of the incision through your chest bone (sternum), you will need to be careful about how you move. Our team, including occupational therapists, work with each patient to help you learn how to manage basic daily tasks, such as putting on clothes and climbing stairs. They will also work with you to design a timeline that maps out when you can get back to normal activities, like lifting heavy objects and driving.

Patients usually can go home after four or five days. Before you are discharged, the care team sets up all the follow-up appointments and gives instructions about prescriptions and restricted activities.

After valve surgery, we follow our patients very closely. Patients usually have a follow-up appointment two or three weeks after they go home and then again after another two weeks. The care team is available 24/7 to answer any questions, and we encourage you to call even with small questions. After the Ozaki procedure, we may follow our patients with annual visits for several years. 

Maher’s Story

When Maher Al-Khoury’s heart started speeding up for no reason, he was told he needed an aortic valve replacement and referred to Dr. Binford, who recommended the Ozaki procedure. 

“It was a very smooth operation,” Maher says. ““My symptoms started improving immediately following surgery, and I haven’t had issues since. One of the most noticeable effects is the time it takes me to walk my dog. I have a German shepherd, Maha, who is almost 2 years old. She is very active. Prior to my surgery, our walks would take one-and-a-half to two hours. My heart would start racing, and I’d have to stop and wait to recover. Now, our walks take 45 minutes.”

Learn more about how the Ozaki procedure helped Maher

What questions should I ask my provider about the Ozaki procedure?

• How many Ozaki procedures have you completed? 
• What kind of outcomes have you seen with the Ozaki procedure?
• What is your success rate in repairing versus replacing valves?
• Should my valve be repaired or replaced?
• How will I be able to get in touch with my surgeon and the rest of the care team after surgery?
• What medications should I stop taking before the Ozaki procedure?

Frequently Asked Questions

Q: What are the differences between the Ozaki procedure and a regular aortic valve replacement?

A: The Ozaki procedure creates a valve made of a patient’s own heart tissue. It does not contain artificial material that can get in the way of the blood flow, and it functions just like a normal aortic valve.

Q: What are longer-term outcomes of the Ozaki procedure?

A: Studies of the first 1,100 patients to receive the Ozaki procedure in Japan show that patients with the Ozaki valves can do as well or better than patients who receive standard tissue valves. Over 12 years, 95% of these patients did not need another operation on their valve, and their valves continued functioning well.