title: Aortic surgery for ascending aortic aneurysms under 5.0 cm in diameter in the presence of bicuspid aortic valve.
abstract: Aneurysm of the ascending aorta may cause acute type A aortic dissection, and the primary aim of a prophylactic operation is avoidance of this life-threatening complication. Current guidelines recommend prophylactic replacement of the aneurysmal ascending aorta at a diameter of ≥5.5 cm. However, several reports have shown that nearly 50% of patients with an acute type A aortic dissection present with an aortic diameter <5.5 cm. It is controversial how to best respond to these observations. Because surgical advances have led to a reduction of early surgical mortality between 1% and 3%, many clinicians believe that surgery is warranted in smaller aortas. Given the frequency of a bicuspid aortic valve (BAV), such a strategy has health implications for this population.
authors: Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany. Electronic address: klaus.kallenbach@med.uni-heidelberg.de.
authors: Klaus
authors: K
authors: Kallenbach
authors: Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: tsundt@partners.org.
authors: Thoralf M
authors: TM
authors: Sundt
authors: Menzies Research Institute Tasmania, Hobart, Australia. Electronic address: Tom.Marwick@utas.edu.au.
authors: Thomas H
authors: TH
authors: Marwick
mesh_terms: D000784:Aortic Dissection / Q000209:etiology / Q000517:prevention & control*; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000592:standards; D004108:Dilatation, Pathologic; D018450:Disease Progression; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: aortic aneurysm; bicuspid aortic valve; surgery