Aortic Valve Repair Using HAART 300 Geometric Annuloplasty Ring: A Review and Echocardiographic Case Series

Published:March 19, 2022DOI:
      Aortic valve repair (AVr) aims to preserve the native aortic leaflets and restore normal valve function. In doing so, AVr is a more technically challenging approach than traditional aortic valve replacement. Some of the complexity of repair techniques can be attributed to the unique structure of the functional aortic annulus (FAA), which, unlike the well-defined mitral annulus, is comprised of virtual and functional components. Though stabilizing the ventriculo-aortic junction (VAJ), a component of the FAA, is considered beneficial for patients with chronic aortic insufficiency (AI), the ideal AVr technique remains a subject of much debate. The existing AVr techniques do not completely stabilize the VAJ which may increase susceptibility to recurrent AI due to VAJ dilation. An emerging new technique showing promise for the treatment of both isolated and complex AI is AVr using HAART 300TM geometric annuloplasty ring (GAR). The GAR is implanted below the valve leaflets in the left ventricular outflow tract (LVOT), providing stability and creating a neo-annulus. As with other AVr subtypes, this procedure has a learning curve. There are unique surgical and echocardiographic aspects of AVr with GAR, including the appearance of the LVOT, the aortic valve leaflets, and their motion which cardiac anesthesiologists and echocardiographers must be familiar with. In this work, using an eight-patient echocardiographic case series, we provide an overview of this novel AVr technique, including some unique aspects of device sizing, patient selection, expected post-repair echocardiographic features, and a review of outcomes data.


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      Linked Article

      • Aortic Valve Repair: The Evolving Frontiers of Aortic Annuloplasty
        Journal of Cardiothoracic and Vascular AnesthesiaVol. 36Issue 11
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          THE TECHNIQUES in aortic valve repair have matured for the management of aortic insufficiency, with or without associated aortic pathology, to offer patients freedom from the complications of prosthetic valves, including thromboembolism, endocarditis, anticoagulant-related hemorrhage, and reoperation due to structural valve deterioration.1-3 This steady evolution has been enhanced by advances, including a repair-oriented classification system, annular stabilization, the standardization of leaflet repair techniques, and a systematic assessment with echocardiography.
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