A modern approach to aortic valve insufficiency: Aortic root restoration via HAART 300 internal annuloplasty ring

J Card Surg. 2021 Nov;36(11):4189-4195. doi: 10.1111/jocs.15947. Epub 2021 Aug 27.


Background and aim of the study: HAART 300 is an internal geometric annuloplasty ring. The safety and efficacy of this novel device in aortic valve (AV) repair in a single referral center are reported.

Methods: Twenty patients with trileaflet AV insufficiency with ascending aorta and/or aortic root enlargement were included. Subannular implantation was performed to correct annular dilatation, whereas concomitant leaflet repair was performed whenever required. All but two patients also received ascending aorta replacement, whereas selective sinus replacement was performed in all but five patients.

Results: Follow-up was for a maximum of 3.8 years and a mean of 2.2 years. Mean age was 54.2 years old. Moderate to severe preoperative AV insufficiency was noted in 75% of patients, whereas 70% of them had an ascending aorta over 45 mm. One patient was lost from follow-up. Overall mortality as well as major complication rates were zero. Early postoperatively, no more than mild AV regurgitation was detected, whereas only one patient appeared with moderate AV regurgitation during our 2.2-year follow-up. New York Heart Association class was also significantly lower compared to preoperative values and valve gradients remained low at last follow-up.

Conclusions: Geometric ring annuloplasty is a safe and effective valve sparing approach to deal with AV insufficiency contributing to overall root reconstruction. Short-term results are excellent rendering this easily reproducible and versatile method very attractive.

Keywords: aortic annulus; aortic root restoration; aortic valve insufficiency; elliptical shape; internal annuloplasty ring.

MeSH terms

  • Antiretroviral Therapy, Highly Active
  • Aorta
  • Aortic Valve / surgery
  • Aortic Valve Insufficiency* / surgery
  • Cardiac Valve Annuloplasty*
  • Humans
  • Middle Aged
  • Treatment Outcome