Adults or other patient groups with congenital heart disease can present with aortic insufficiency. This is most likely due to annular dilation, but it can also be related to other factors such as dysmorphic leaflets, leaflet prolapse, or effacement of sinotubular junction, among others.
This video demonstrates the repair of an aortic valve in congenital heart disease. The HAART ring technique, one of the techniques used in the video, is a reliable way to treat annular dilation. Leaflet calcification can be reduced with the use of cavitron ultrasonic surgical aspirator (CUSA). Leaflet prolapse may occur primarily or after annular reduction, and plication of the leaflet free edge can improve functional height and improve apposition.
Both patients, whose treatment is demonstrated in this video, had a previous history of complex congenital heart conditions with multiple surgeries. Both demonstrated significant improvement in aortic insufficiency without any significant gradient across that aortic valve; this has remained stable at six months follow-up.
Reference
- Surgical correction of aortic regurgitation using a HAART 300 rigid aortic ring: A novel method to standardize aortic valve repair. Radoslaw G et al. Cardiol J. 2019;26(6):799-801
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