Comparison of Ozaki and Ross procedures for paediatric aortic valve disease: a systematic review and meta-analysis

Abstract Objectives: To compare the clinical efficacy and prognosis of Ozaki procedure and Ross procedure in the treatment of paediatric aortic valve disease. Methods: According to the predetermined inclusion and exclusion criteria, relevant clinical studies were comprehensively searched in three databases, and relevant data were extracted for analysis and comparison. Results: This meta-analysis included four retrospective cohort studies with a total of 243 patients (117 undergoing Ozaki procedure and 126 undergoing Ross procedure). There were no significant difference in the in-hospital all-cause mortality [odds ratio = 1.38; 95% confidence interval: 0.38, 5.07, p = 0.63] and all-cause mortality during the follow-up period [odds ratio = 1.85; 95% confidence interval: 0.54, 6.32, p = 0.32] between Ozaki procedure and Ross procedure. The reoperation on the aortic valve [odds ratio = 10.48; 95% confidence interval: 2.22, 49.40, p = 0.003] was higher in the Ozaki procedure than in the Ross procedure. There were no patients who underwent pulmonary valve reoperation after Ozaki procedure [odds ratio = 0.21; 95% confidence interval: 0.03, 1.23, p = 0.08]. The cumulative reoperation rate after Ozaki procedure [odds ratio = 2.29; 95% confidence interval: 0.93, 5.66, p = 0.07] was higher than that of Ross procedure, but the difference was not statistically significant. The cardiopulmonary bypass time after Ozaki procedure [odds ratio = −32.09; 95% confidence interval:−45.05, −19.14, p < 0.00001] was shorter than that of Ross procedure. The incidence of postoperative complications [odds ratio = 0.24; 95% confidence interval: 0.04, 1.62, p = 0.14], aortic cross-clamping time [odds ratio = −20.39; 95% confidence interval: −43.68, 2.90, p = 0.09], ventilator assistance time [odds ratio = 1.71; 95% confidence interval: −42.70, 46.13, p = 0.94], and ICU time [odds ratio = −0.38; 95% confidence interval: −0.93, 0.16, p = 0.17] in Ozaki procedure was not statistically significant compared to Ross procedure. Conclusions: In the treatment of children with aortic valve disease, there is no statistically significant difference between the Ozaki procedure and the Ross procedure in terms of freedom from reoperation and all-cause mortality.