[HSF] Bicuspid aortic valve and dilated ascending aorta

[zzhoumd at pol.net]

Dr. Borger's article say 4.5cm instead of 4cm

> Tom Martin is 300% right!
>
> Dilated ascending aortas and/or aortic roots should be replaced in BAV
> patients whenever their diameter reaches 40 to 45 mm. If some one needs
> more scientific information here are two good papers, dealing with this
> topic:
>
>
> Borger et Al. Should the ascending aorta be replaced more frequently in
> patients with bicuspid aortic valve disease?
> J Thorac Cardiovasc Surg 2004; 128: 677-83
>
> 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 Montsouris
> 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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