[HSF] Bicuspid aortic valve and dilated ascending aorta

[tdmartin2000 at aol.com]

Sorry I have not responded to this earlier but I have been too busy doing redo complete sternotomies for patients that had previous bicuspid aortic valves replaced with "dilated" (4 cm) aortas. 
That is supposed to be funny but in reality I just did a redo in a patient that had a bicuspid AVR several yrs ago and was refered to me with a 7 cm ascending. I actually see quite a few pts also that have had previous bicspid AVR's that come to us with acute dissections. Patients with bicuspid aortic valves and dilated ascendings have abnormal collagen and WILL have a problem in the future.
My advice in this area is- at the minimum AVR plus ascending if the aorta is 4cm or greater and if the sinuses are significantly enlarged, do a root.
As for the "mini" sternotomy or minimally invasive approach to the aortic valve my question is WHY!? There is no real benefit to the patient in any fashion and it is harder to do.
 
Tom Martin
U of Florida
Gainesville
 
 
-----Original Message-----
From: prasannasimha at gmail.com
To: OpenHeart-L at lists.hsforum.com
Sent: Mon, 23 Apr 2007 10:27 PM
Subject: Re: [HSF] Bicuspid aortic valve and dilated ascending aorta


5.0 cm does not merit "prophylactic " replacement of the ascending aorta. 
Prasanna 
 
Zhandong Zhou wrote: 
> To Forum, 
> 
> I have a 51 year old patient with bicuspid aortic valve, severe AR > with 4.0 cm root. choices between mini-invasive AVR (through 2nd > intercostal space, 2.5 inch incision) vs full sternotomy with Bentall. > I personally prefer mini AVR then see what happens in the future. 
> 
> Any suggestions? 
> 
> Z Zhou 
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