This study addressed midterm outcomes with the hemispherical aortic annuloplasty reconstructive technology (HAART) ring used for aortic valve repair (AVr). Seventy-one patients had AVr using the HAART ring—53 had a trileaflet valve and 18 had a bicuspid valve. Their median age was 54 years old and 79 percent were male. Many patients needed concomitant interventions such as arch repair (77 percent) or a root procedure (46 percent). At a mean follow up time of 3.9 ± 1.1 years, freedom from reoperation was 96 percent. Eleven patients had moderate or higher aortic insufficiency (AI) during surveillance, and all of these patients had a trileaflet valve. Three patients suffered ring dehiscence. The authors recommend caution when using the subannular approach for stabilization in patients with trileaflet aortic valves.