title: Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves: A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
abstract: Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (Circulation. 2010;121:e266-e369) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (Circulation. 2014;129:e521-e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.
authors.forename: Loren F
authors.initials: LF
authors.lastname: Hiratzka
authors.forename: Mark A
authors.initials: MA
authors.lastname: Creager
authors.forename: Eric M
authors.initials: EM
authors.lastname: Isselbacher
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
authors.forename: Rick A
authors.initials: RA
authors.lastname: Nishimura
authors.forename: Robert O
authors.initials: RO
authors.lastname: Bonow
authors.forename: Robert A
authors.initials: RA
authors.lastname: Guyton
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Halperin
authors.forename: Glenn N
authors.initials: GN
authors.lastname: Levine
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Anderson
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
authors.forename: Sana M
authors.initials: SM
authors.lastname: Al-Khatib
authors.forename: Kim K
authors.initials: KK
authors.lastname: Birtcher
authors.forename: Biykem
authors.initials: B
authors.lastname: Bozkurt
authors.forename: Ralph G
authors.initials: RG
authors.lastname: Brindis
authors.forename: Joaquin E
authors.initials: JE
authors.lastname: Cigarroa
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
authors.forename: Lee A
authors.initials: LA
authors.lastname: Fleisher
authors.forename: Federico
authors.initials: F
authors.lastname: Gentile
authors.forename: Samuel
authors.initials: S
authors.lastname: Gidding
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
authors.forename: John
authors.initials: J
authors.lastname: Ikonomidis
authors.forename: José
authors.initials: J
authors.lastname: Joglar
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kovacs
authors.forename: E Magnus
authors.initials: EM
authors.lastname: Ohman
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Pressler
authors.forename: Frank W
authors.initials: FW
authors.lastname: Sellke
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.forename: Duminda N
authors.initials: DN
authors.lastname: Wijeysundera
mesh_terms: D026683:Advisory Committees / Q000592:standards*; D000572:American Heart Association; D001018:Aortic Diseases / Q000175:diagnosis / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D002309:Cardiology / Q000379:methods / Q000592:standards*; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D014481:United States
keywords: AHA Scientific Statements; anticoagulation therapy; heart valves; thoracic aortic aneurysm; thoracic aortic disease; thoracic aortic dissection; valvular heart disease