Article and Video: Rahaf Sholi 12\14\2023

“I was in pain, I felt a tightness in my chest, and I didn’t know the reason”, said Nasra Kabush.

Nasra Kabush is a 68-year-old-woman, with green eyes and a smiling warm face from Nablus city. She went on to describe her journey with her illness and treatment. 

“I visited a doctor to see the source of this pain, and he told me that I must talk to a cardiac specialist”, Nasra explained and continued, “I went to the specialist, and he discovered that I have a dysfunctional valve within my heart, for which I needed to have an operation.” 

Nasra came to An-Najah National University Hospital and met Dr. Issa Al-khdour- a Cardio-thoracic surgeon. After reviewing her case, Dr.Issa explained to the patient and her family the possibility of going for a qualitative operation called (Ozaki Surgery) and they were happy to proceed. 

 

Ozaki Procedure 

Ozaki procedure: is a type of open-heart surgery performed on patients with aortic valve disorders which is defined as a malfunction in the aortic valve that will disturb the normal blood flow from the left ventricle of the heart to the systemic circulation eventually leading to heart failure if not treated properly. It was named Ozaki after Shigeyuki Ozaki, a Japanese surgeon, who modified this technique in the early 2000s after many years of research and surgical trials. 

To understand this procedure, let’s first describe how your heart works. Blood enters and exits your heart with each beat, delivering oxygen-rich blood to all of the body's tissues and organs. There are four valves that precisely control blood flow within the heart, and between its chambers and the body at large, together they govern adequate and unidirectional blood flow from the heart to the body and vice versa.

One of these valves, known as the aortic valve, separates the heart's left ventricle—the main left chamber of the heart—from the aorta, the body's biggest artery. This valve is critical in regulating blood flow from the heart to the rest of the body. The function of the aortic valve is maintained by three leaflets, or cusps. These leaflets open with each heartbeat to enable blood to flow from the heart into the aorta and then close to prevent blood from returning to the heart. When the aortic valve fails, it can lead to major heart complications, like heart failure.

Dr. Issa Al-khdour - the surgeon who performed the procedure on Nasra said “Luckily, there are treatment options for aortic valve disease, including aortic valve replacement and a procedure known as aortic valve neocuspidization, or Ozaki procedure.”

 “The goal of the Ozaki procedure is to replace the non-working valve with a new one using the patient’s own tissue ( the sac around the heart) without the need for a prosthetic valve”, Dr. Issa clarified and continued, “This procedure requires special equipment and high skills, in order to design the aortic valve three c leaflets, then to use the re-constructed leaflets to replace the old valve.”  The new cusps of the aortic valve are then sutured at the site where it controls blood flow between the left ventricle and the ascending aorta. 

 

The advantages of the Ozaki procedure

Dr. Al-Khdour Pointed many benefits of using the patient’s own tissue, such as: 

• Using such a technique, the patient is not required to take blood-thinning medications for life, they are only indicated for 2 or 3 months after the operation which will dramatically improve the patient’s quality of life. 

• No prosthesis must be implanted inside your body; thus, lower risk of infection.

• The procedure completely resolves the pathology that impairs blood flow between the heart and the rest of the body.

 

After the Ozaki procedure, how does one recover?

Nasra said, “I woke up after the operation, and they told me that I'm in the cardiac intensive care unit (CICU) as it was explained before the surgery.”   Patients may need to spend one or two days in the cardiac intensive care unit, then a few more days in the hospital where they will be closely monitored until they recover from the operation and are well enough to be discharged home.

Elias Ashqar a CICU nurse at An-Najah National University Hospital stated, “Although Ozaki procedure is qualitative, patients still receive the same care that is indicated for all open-heart operations.” 

“In the end”, Dr. Issa Al-khdour told us, “Here at our institute we are dedicated to use every reported successful and trusted technique that helps to relieve patient’s pain and improve their quality of life.”