Aortic complications after bicuspid aortic valve replacement: long-term results

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease

“…Aortic dissection is well described in BAV, particularly if associated with aortic coarctation. [333][334][335] The risk of aortic dissection in BAV is estimated at 5 to 9 times that of the general population. 334,336…”

Risk factors for pre, intra, and postoperative hospital mortality in patients undergoing aortic surgery

“…Even in the absence of significant aortic valve disease, there is often association with dilatation of the aortic root, annuloaortic ectasia and aortic dissection. After replacement of the bicuspid aortic valve, this finding is reported as a risk factor for late acute dissection and ascending aorta aneurysm [9][10][11].…”

Surgical Treatment of Bicuspid Aortic Valve Disease

“…Ascending aortic dilatation occurs more frequently and at a younger age in patients with a BAV than in patients with a tricuspid aortic valve (Hahn et al, 1992;Nkomo et al, 2003), and, according to Yasuda et al (2003), the aorta continues to dilate, even after valve replacement. Because of this, reoperation for aortic aneurysm as well as late aortic dissection and sudden rupture are significantly higher in this group of patients (Russo et al, 2002;Borger et al, 2004). Although the proximal ascending aorta is thought to be the most commonly affected segment (Nkomo et al, 2003;Alegret et al, 2003;WesthoffBleck et al, 2005;Tadros et al, 2009;Biner et al, 2009), recent computed tomographic angiography or magnetic resonance angiography and echocardiography studies of the thoracic aorta morphology in patients with BAV show more diffuse and distinct patterns of aortopathy extending from the aortic root to the proximal aortic arch (Westhoff-Bleck et al, 2005;Fazel et al, 2008;Nazer et al, 2010).…”