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Andrew Gogbashian
Ramanan Umakanthan
Aravind T. Rangaraj
John A. Fox
Lawrence H. Cohn
Frederick Y. Chen
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Ann Thorac Surg 2007;84:1001-1005
© 2007 The Society of Thoracic Surgeons

New Technology

Correction of Aortic Insufficiency With an External Adjustable Prosthetic Aortic Ring

Andrew Gogbashian, MDa, Ravi K. Ghanta, MDa, Ramanan Umakanthan, MDa, Aravind T. Rangaraj, MDa, Rita G. Laurence, BSa, John A. Fox, MDb, Lawrence H. Cohn, MDa, Frederick Y. Chen, MD, PhDa,*

a Division of Cardiac Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
b Division of Cardiac Anesthesia, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

Accepted for publication February 22, 2007.

* Address correspondence to Dr Chen, Division of Cardiac Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 (Email: fchen{at}partners.org).

Purpose: Less invasive, valve-sparing options are needed for patients with aortic insufficiency (AI). We sought to evaluate the feasibility of reducing AI with an external adjustable aortic ring in an ovine model.

Description: To create AI, five sheep underwent patch plasty enlargement of the aortic annulus and root by placement of a 10 x 15 mm pericardial patch between the right and noncoronary cusps. An adjustable external ring composed of a nylon band was fabricated and placed around the aortic root.

Evaluation: Aortic flow, aortic pressure, and left ventricular pressures were measured with the ring loose (off) and tightened (on). Mean regurgitant orifice area decreased by 86%, from 0.07 ± 0.03 cm2 (ring loose, off) to 0.01 ± 0.00 cm2 (ring tightened, on) [p < 0.01]. The regurgitant fraction decreased from 18 ± 4% to 2 ± 1% [p < 0.01]. The ring did not significantly affect stroke volume and aortic pressure.

Conclusions: An ovine model of aortic root dilatation resulting in acute AI has been developed. In this model, application of an external, adjustable constricting aortic ring eliminated AI. An aortic ring may be a useful adjunct in reducing AI secondary to annular dilatation.


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Ann. Thorac. Surg. 2007 84: 1006. [Extract] [Full Text] [PDF]



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