Do we all need to learn aortic valve repair the HAART way?

We read with great interest the recent article by Lancaster and colleagues1 describing hemispherical aortic annuloplasty reconstructive technology (HAART) in adolescents, which requires implantation of a rigid ring inside the aorta (Figure  1, A). A few immediate questions come to mind. Is implantation of an internal ring necessary if efficient and durable stabilization could be achieved with other annuloplasty techniques? Would the expected endothelization of the ring induce fibrosis in the high-shear-stress subaortic area? Would th is, in turn, create an iatrogenic subaortic membrane and induce the spread of the fibrosis into the base of the cusps? Would this ring influence the valve function long term? These questions remain to be answered and are of great importance, especially because durable stabilization techniques with p roven long-term excellent results already exist.

Source: The Journal of Thoracic and Cardiovascular Surgery - September 19, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Igor E. Konstantinov, Alexey Zubritskiy Tags: Letter to the Editor Source Type: research