[HSF] Bicuspid aortic valve and dilated ascending aorta

[Jean BACHET]

 Tom Martin is 300 % right!

If you want some more scientific information you may red those two papers:


Von Kodolitsh Y et al. Predictors of proximal aortic dissection at the time
of aortic valve replacement
Circulation 1999; 100 (supp II) II: 287-94



Jean BACHET,
Institut Mutualiste Monsouris.
Paris France.
----- Original Message ----- 
From: <tdmartin2000 at aol.com>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Friday, April 27, 2007 6:15 AM
Subject: Re: [HSF] Bicuspid aortic valve and dilated ascending aorta


> 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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