Geometric ring annuloplasty as an adjunct to aortic valve repair: clinical investigation of the HAART 300 device

Abstract

Geometric ring annuloplasty was a safe and effective adjunct to aortic valve repair. Initial correction of annular dilatation seemed to facilitate overall reconstruction. Because most early repair failures were technical, increasing experience with geometric ring annuloplasty for aortic valve reconstruction has the potential to standardize and improve outcomes.

Transfemoral transcatheter aortic valve implantation after aortic valve repair with HAART 300 device

“…Therefore, this method is expected to become a standard for treating tricuspid AR‐related disorders. However, our patient developed an early repair failure, similar to that observed in the first trial of AVP with the HAART device . Our TTE revealed only central jet and the absence of any valve perforation related to infection or abscess.…”

Aortic annulus does not dilate over time after aortic root remodeling with or without annuloplasty

“…7 The most common circumferential annular supports currently used are the suture annuloplasty, 7 the implantation of an expansible ring, 8 and the insertion of an internal rigid device. 9 The internal ring annuloplasty has an apparent advantage of annular reduction at the basal plane without root dissection. There are, however, no mid-term data, and the proximity of the device to the cusps has been subject of concern.…”

“…Reoperations were necessary in 7 of 65 (10.8%) after implantation of this ring during mean follow-up of 2 years. 9 External ring annuloplasty can stabilize the annulus at the same level as the first suture line of the aortic valve reimplantation operation. Remodeling with the expansible ring may preserve root distensibility, which is an advantage compared with reimplantation.…”

“…3,6 Therefore, different modifications of aortic annuloplasty have been proposed: external suture annuloplasty, 7 external ring annuloplasty, 8 and internal ring annuloplasty. 9 Each has both advantages and disadvantages, and the superiority of one alternative over others remains unclear because of the lack of long-term data. We have consistently applied external suture annuloplasty in cases with pre-existing annular dilatation regardless of root replacement because it is simple and effective.…”

First uses of HAART 300 rings for aortic valve repair in Poland – 4 case studies

“…The use of an internal geometric annuloplasty ring (HAART), proposed by Rankin in 2011, not only restores the appropriate dimensions of the AVJ, but also stabilizes it and, most importantly, reconfigures the aortic ostium to its optimal, elliptical shape [ 4 ].…”