Benefits of AVNeo for Children

AVNeo (also known as the Ozaki Procedure) for Children is increasing its recognition as a substitute for the well-established ROSS procedure. AVNeo is less invasive/complicated with the potential for less side effects. Ask your doctor about the AVNeo procedure for your child.

Benefits and Risks of the AVNeo Procedure


Natural material

  • AVNeo uses your own tissue to create valve. So minimum foreign materials, such as sutures, will be implanted in your body
  • The AVNeo™ procedure, unlike the ROSS procedure, does not require a homograft (valve from another human), therefore you are less likely to have allergic events.

Natural blood flow

  • AVNeo recreates a natural-like valve, allowing your annulus (the fibrous skeleton of the heart at the base of your aorta) to expand and contract like a normal healthy aortic valve does. Improving the blood flow through the aortic valve to the rest of your body will allow your child to play sports or regain the active lifestyle they had before surgery.
  • The ROSS procedure is a very durable and established surgery that will allow an active life, similar to AVNeo.2

No drugs

  • No need for life long medication, free from anti-coagulations (blood thinning mediation) to support your children’s active lifestyle.2

Less Complicated

  • The ROSS procedure has a long-term durability data and good results 1. But the ROSS procedure is also highly invasive. During a ROSS procedure the aortic valve is replaced with the patient’s own pulmonary valve. The pulmonary valve is then replaced with a homograft (a transplant from another human body). This creates a two-valve disease out of a one valve disease.
  • AVNeo repairs the single damaged aortic valve and leaves the pulmonary valve as is. AVNeo does not require any homograft, unlike the ROSS procedure, allowing the pulmonary valve to grow naturally and without any artificial material insertion.


  • The Durability of the AVNeo procedure is still being evaluated. There is currently 12 years of data for the adults showing promising results. For the Pediatric cases, Boston Children’s Hospital has been performing AVNeo since 2014 with good results, but the long-term data is still to be investigated.3


  • Typically, AVNeo does not require any anti-coagulants (blood thinning medication), leaving the option for women to become pregnant.4

  1. Luciani GB, Lucchese G, Carotti A, Brancaccio G, Abbruzzese P, Caianiello G et al (2014) Two decades of experience with the Ross operation in neonates, infants and children from the Italian Paediatric Ross Registry. Heart 100:1954–1959
  2. Polito A, Albanese SB, Cetrano E, Forcina S, Cicenia M, Rinelli G, Carotti A. Aortic Valve Neocuspidalization May Be a Viable Alternative to Ross Operation in Pediatric Patients. Pediatr Cardiol. 2021 Mar;42(3):668-675. doi: 10.1007/s00246-020-02528-3. Epub 2021 Jan 4. PMID: 33394106; PMCID: PMC7780600.
  3. Baird CW, Marathe SP, Del Nido PJ. Aortic valve neo-cuspidation using the Ozaki technique for acquired and congenital disease: where does this procedure currently stand? Indian J Thorac Cardiovasc Surg. 2020 Jan;36(Suppl 1):113-122. doi: 10.1007/s12055-019-00917-9. Epub 2020 Jan 9. PMID: 33061192; PMCID: PMC7525707.
  4. Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014;63:e57–185

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