There is very little evidence to suggest that bicuspid aortic valve patients need different treatment than patients with a "normal" aortic valve. The studies that indicate that the risk of aortic dissection was higher in bicuspid aortic valve patients were old, autopsy studies that definitely provide a bias view on the subject. There are numerous studies in patients who were followed and the growth of their ascending aorta was measured and clinical outcomes were measured. There was either no aortic dissection or other aortic complications during their follow-up. There will be a article coming out in the Annals of Thoracic Surgery from Dr. Griepp and the Mount Sinai Aortic Group in the next couple months related to this topic. Patients with bicuspid aortic valves can be followed carful before they may need surgery.

Careful Surveillance of Thoracic Aortic Aneurysms

Most patients have a significant amount of anxiety when they are informed that they have an aneurysm. If the aneurysm is too small to require surgery-diligent medical therapy is appropiate. Enrollment in an established aortic surveillence program is prudent. The annual CT scan or MRI can provide a great deal of reassurance that medical therapy is working. Please take charge of your care by seeking the appropiate aortic team. Look at my previous posting for aortic centers in the US.

Read Newsletter from Mount Sinai at www.aortarepair.com

Aortic Center in United States: (no particular order)

1. University of Pennsylvania

2. Mount Sinai Medical Center

3. Stanford University

4. John Hopkins Medical Center

5. Baylor University Medical Center

6. University of Texas at Houston

7. Cleveland Clinic

Don't forget Aortic Symposium is this week!

New and improved aortic website!!! www.aortarepair.com

Do I need Aneurysm surgery?

Always ask your cardiologist or cardiac surgeon prior to signing up for surgery what are your risk if you continue conservative management of your aneurysm. Many times surgery is performed because the individuals taking care of you are nervous about leaving the aneurysm alone and continuing surveillance. I hear this often when people come to see me for a second opinion. Most of the time I recommend conservative management and place the patient in our surveillance program. So be careful who is recommending surgery and how many patients they are treating with aneurysms. Many 5 cm ascending aortic aneurysms can be watched carefully. Seek a second opinion from an aortic reference center.