Additional caption: 
[A] Velocity-coded 4D flow MRI reveals an accelerated eccentric asymmetric flow jet (indicated by yellow and red streamlines) and a pronounced vortical flow pattern (arrows) in the ascending aorta before surgery.  The flow jet impacts and travels along the right aortic wall. [B] After surgery, velocity-coded 4D flow MRI shows reduced vortical flow with a more cohesive central flow pattern more parallel to the vessel wall of the ascending aorta. 
 

Bicuspid aortic valve (BAV) is the most common congenital anomaly of the human heart.
heart. Almost half of BAV patients develop leakage of the aortic valve at a young age, which, if left untreated, leads to progressive heart failure. Most patients are still treated with an artificial valve prosthesis, which is associated with a lifelong increased risk of prosthesis-related complications. Therefore, repair of the patient's own leaking aortic valve is an important treatment strategy in this patient population. The main limitation of current techniques is the lack of surgical standardization, which is associated with suboptimal results. The most difficult aspect of repair is the treatment of the dilated aortic valve annulus. Various techniques have been developed for this, but no comparative analyses are available.
The aim of our multicentre randomized controlled trial is to test the
hypothesis whether a standardized stabilization technique of the aortic valve ring using HAART 200 Device leads to better repair results compared to previous non-standardized techniques.

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