Aortic Insufficiency Clinical Trial
Official title:
HAART 200 Aortic Valve Annuloplasty During Bicuspid Aortic Valve Reconstruction Trial
The HAART 200 "Aortic Annuloplasty during Bicuspid Aortic Valve Reconstruction" Trial is a prospective, non-randomized, multi-center trial to evaluate the safety and effectiveness of the HAART 200 bicuspid annuloplasty ring when used to surgically stabilize the aortic valve annulus in patients undergoing repair of bicuspid aortic valves (BAV) for predominant aortic insufficiency (AI).
Aortic valve disease is the most common valvular heart disease with approximately 200,000
patients per year undergoing conventional aortic valve replacement in North America and
Europe. Around 60% of valves have Aortic Stenosis (AS) and 40% of have Aortic Insufficiency,
which is the failure of the aortic valve to close completely during diastole, causing blood
to flow from the aorta back into the left ventricle. Bicuspid valve morphology is present in
a fourth to a third of patients coming to surgical intervention, and constitutes a very
important subset. Several conditions are associated with bicuspid disease, including
ascending aortic or root aneurysms in up to a third.
Traditional management of aortic valve and root disease has been with aortic valve
replacement, with or without root replacement (Bentall Procedure). However, as has been
observed in patients with mitral valve repair, the option of maintaining one's reconstructed
native valve versus a replacement, either bioprosthetic or mechanical, can have multiple
benefits. The advantages of repair include: the avoidance of prosthetic valve related
complications and structural degeneration with bioprosthetic valves over 10-15 years and
elimination of the need for anticoagulation and related problems with mechanical valves in
younger patients. The significantly lower rate of endocarditis after repair is a major
impetus to increasing performance of BAV reconstruction. Thus, aortic valve repair currently
is established as an excellent option for patients with BAV. However, with connective tissue
disorders being an inherent feature of BAV, outcomes have been less stable long-term than
for trileaflet repair, primarily because of late annular redilatation in BAV disease.
Therefore, this study is designed to evaluate the safety and effectiveness of annular
stabilization with a bicuspid annuloplasty ring in patients undergoing repair of a bicuspid
aortic valve for predominant aortic insufficiency.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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