Four-dimensional magnetic resonance after ascending aorta replacement and aortic valve repair with HAART 300 internal annuloplasty ring

BACKGROUNDThe hemispherical aortic annuloplasty reconstructive technology (HAART) is an internal geometric annuloplasty ring designed to restore a natural elliptical shape to the aortic annulus as part of aortic valve repair. We present four-dimensional flow hemodynamic analysis before and after implementation of the HAART ring in patients undergoing ascending aortic replacement. METHODSAortic hemodynamics over the cardiac cycle were visualized using time-resolved three-dimensional pathlines. Velocity streamlines tangent to the time-resolved velocity vector field were used to demonstrate instantaneous aortic hemodynamics. Peak velocities, forward and retrograde flow were calculated at nine planes placed along the midline of the thoracic aorta. Systolic wall shear stress and peak viscous energy loss over the cardiac cycle were calculated. RESULTSHAART patients displayed similar or improved flow profiles after surgery when compared to a patient undergoing ascending aortic replacement alone. CONCLUSIONThere may be a trend towards improved flow dynamics in patients undergoing HAART ring implantation.