[HSF] Bicuspid aortic valve and dilated ascending aorta

[zzhoumd at pol.net]

You need to see the patient to believe, without sternotomy, in two weeks
they can do anything. For AR, the surgery is not difficult at all.



> 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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