HJNO Jul/Aug 2023

HEALTHCARE JOURNAL OF NEW ORLEANS  I  JUL / AUG 2023 43 itive long-term results, we are optimistic about the potential success of the Ozaki procedure in the pediatric population. The Ozaki procedure is a groundbreaking ad- vancement for the Gulf South, and we are thrilled to offer this novel alternative for patients like Skylynn. n Frank Pigula, MD, joined Children’s Hospital New Orleans as chief of pediatric cardiothoracic surgery and co-director ofThe Heart Center inJanuary 2021. Pigula brings a level of experience and expertise in congenital heart surgery that is unmatched in the re- gion.Pigula’s extensive background includes 12 years as clinical director of pediatric cardiothoracic surgery at Boston Children’s Hospital, the No. 1 ranked Chil- dren’s Hospital in the country by USNews andWorld Report . Pigula has also held leadership positions in cardiac surgery at Children’s Hospital of Pittsburgh, Norton Children’s (formerly Kosair Children’s), and most recently at AdventHealth Children’s Hospital in Orlando, Florida. After completing his residency in surgery at the University of Vermont, Pigula com- pleted fellowships in cardiothoracic surgery at the University of Pittsburgh and in pediatric cardiotho- racic surgery at Boston Children’s Hospital. An ac- complished academician, he is the author of more than 140 peer-reviewed articles and 25 book chapters and invited reviews. Frank A. Pigula, MD Chief of Pediatric Cardiothoracic Surgery and Co-Director of The Heart Center Children’s Hospital New Orleans After reviewing Skylynn’s case, it was determined that she would be a good can- didate for valve repair or valve replace- ment surgery. Repairing the aortic valve would not be feasible because her aorta had begun to stretch. If the repair wasn’t going to work, we would traditionally opt for mechanical valve replacement surgery even though that means she would be on lifelong blood thinners, which would limit her physical activities. With Skylynn’s case, we had an alternative that would create the results we needed without these lifelong challenges — the Ozaki procedure. About the Ozaki procedure During the Ozaki procedure, the peri- cardium, a thin, protective sac surround- ing the heart is opened to expose the aortic valve and the ascending aorta. The diseased aortic valve is carefully excised, removing the damaged valve leaflets while preserving the aortic root and annulus. Using the patient’s own pericardial tis- sue, a new valve is custom-made. The peri- cardial valve is shaped and sewn together to form three leaflets, mimicking the natu- ral anatomy of the aortic valve. The newly created pericardial valve is carefully su- tured within the patient’s aortic annulus, ensuring proper alignment and function. The Ozaki procedure for children is one that few hospitals offer and is an alterna- tive for patients who may not be suitable candidates for traditional valve replace- ment. Several factors make pediatric Oza- ki more technically challenging including smaller aortic root and annulus. The Oza- ki technique for children uses the child’s aortic root measurements with a custom sizing template. After the child’s existing aortic valve leaflets are removed, the peri- cardial tissue is custom fit for the individu- al, and new leaflets are created by the sur- geon to reconstruct the valve. Unlike mechanical valve replacements that use artificial materials or animal tis- sue, the Ozaki procedure does not require patients to take lifelong anticoagulant therapy since their blood does not adhere to the valve or circulate in a manner that leads to blood clots, which can be a major concern with artificial heart valves. The Ozaki technique is particularly advanta- geous to children. The newly created valve with the three leaflets has the potential to expand as the heart grows, possibly ex- tending the life of the repair. Following Skylynn’s Ozaki procedure, her intraoperative imaging showed an ex- cellent surgical outcome without leakage or narrowing of the aortic valve. She was transferred to the cardiac intensive care unit and spent just six days in recovery. Af- ter discharge, she is doing remarkably well. While the Ozaki procedure has been uti- lized for years in adults with aortic valve dysfunction and has demonstrated pos- Frank Pigula, MD, with patient Skylynn.