Should aortas in patients with bicuspid aortic valve really be resected at an earlier stage than tricuspid? CON.
Bicuspid aortic valve (BAV)-associated aortopathy is a complex phenomenon, and the current lack of univocal interpretation of its causes and treatment can be ascribed to the multiform nature of its clinical presentation. Although there is strong bias in the literature favoring more aggressive treatment of ascending aortic dilatation in patients with BAV, evidence supporting this opinion is lacking. This review discusses some of the relevant issues relating to causation to facilitate a better analysis of the current recommendations used to guide surgical management, and concludes that treatment should be tailored by individual valvular pathology, clinical phenotype, and relevant comorbidities, using well-documented evidence-based clinical size criteria.
Coady
Michael A
MA
Division of Cardiothoracic Surgery, Alpert School of Medicine at Brown University, Rhode Island Hospital, Two Dudley Street, Suite 500, Providence, RI 02905, USA. mcoady@lifespan.org
Stockwell
Philip H
PH
Robich
Michael P
MP
Poppas
Athena
A
Sellke
Frank W
FW
D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities*; D006349:Heart Valve Diseases / Q000150:complications* / Q000151:congenital; D006801:Humans; D012307:Risk Factors; D013997:Time Factors; D014261:Tricuspid Valve / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*