[HSF] Aortic Aneurysms and Bicuspid Valves

[prasannasimha]

10 cm root ? in the presence of the prosthesis - at what level was the 
measurement done - obviously not ventriculoaortic junction - was it at 
the ST junction or maximal infracoronary level diameter at the sinuses ?
Prasanna

Hgrmd at aol.com wrote:
> Dear Members,
>   I did an interesting case 3 days ago in which a 50 yo man had  atypical 
> chest pain.  A CT revealed a 10 cm aortic root!  That's the  biggest root I can 
> recall seeing. There was a well-functioning Starr-Edwards  aortic valve that 
> had been implanted in '87 for bicuspid stenosis.  Even 20  years ago, I thought 
> no one was using the Starr-Edwards in the aortic  position.  Anyway, I did an 
> uneventful Bentall, and the patient is  currently doing well.
>   My question for the aortic experts of HSF (I certainly don't  consider 
> myself one) is what minimum aortic diameter would you now recommend  Bentall 
> instead of simple AVR for symptomatic bicuspid stenosis?  I've  heard and read that 
> the bicuspid aorta has the same biology as Marfan's.   Comments?
> Hal
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