[HSF] Bicuspid aortic valve and dilated ascending aorta

[Hgrmd at aol.com]

Dear Dr. Zhou,
  I've never done an AVR through a 2nd ICS mini thoracotomy.  I  always use 
the "L" from the sternal notch to the right 4th ICS.  It's not  as nice 
cosmetically, but you can easily go to a full sternotomy should  technical 
difficulties arise.  This approach is especially nice for  redos.
  As for the 4 cm aorta, I don't think that meets criteria in a non  Marfan's 
patient.  I thought the cut off was 4.5 cm.  Tom Martin, what  do you think?
Hal



************************************** See what's free at http://www.aol.com.