This is an excerpt from the article.

“The Duke Children’s Pediatric & Congenital Heart Center (Duke University Medical Center, Durham, USA) treats the entire spectrum of patients with complex congenital heart disease. In this article, Cardiovascular News focuses on how the centre manages patients with congenital aortic valve disease—specifically, their use of the HAART 200 and HAART 300 (both BioStable) internal aortic valve annuloplasty rings.

Patients with congenital aortic valve stenosis may present with the typical trileaflet valve, bicuspid valves or even unicuspid leaflets. Joseph Turek, the executive co-director of the centre, explains: “These children are born with stenosis of their own valve [i.e. it is not acquired aortic valve stenosis]. Something happens during embryonic development wherein the valve did not develop to the right size. A lot of these patients end up having bicuspid or unicuspid leaflets as well.”

He adds that the management of these patients “has really advanced over the last 20 years or so, and the vast majority of institutions now offer balloon valvuloplasty. It is very effective”. However, a caveat of balloon valvuloplasty is that it can cause aortic valve insufficiency. According to Turek, “you have exchanged the problem of aortic stenosis with the problem of aortic valve insufficiency”. Therefore, the treating physicians at The Duke Children’s Pediatric & Congenital Heart Center face the challenge of managing patients with aortic regurgitation as well as aortic stenosis or those with pure aortic regurgitation. “We need to be able to address this challenge,” Turek comments.

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