Thread by @MasriAhmadMD

A great case of bicuspid-associated aortopathy.
How common is aortic dissection in BAV? To date, many surgeons operate on patients with dilated aortas in the 4.5-5.0 cm range without concomitant severe valve disease. But, how about the evidence so far?
#cardiotwitter #MedEd

https://twitter.com/VLSorrellImages/status/1067877006006779904

1) IRAD had 1.9% BAV patients in a 2006 report (out of 303 type A dissections)
ncbi.nlm.nih.gov/pubmed/16820599

2) GenTAC registry had 2 dissections / 772 BAV (follow-up 3.6 years, outcome ascertained in 88%)
ncbi.nlm.nih.gov/pubmed/27282895

3) In a contemporary cohort of 1890 BAV patients; only 2 dissected (women, max diameter 4.5 and 5.5 cm). During the same period of 2003-2007, 6 patients out of 1896 presented with dissection. ncbi.nlm.nih.gov/pubmed/26825434

4) In a systematic review we've done on non-surgical studies: 38 patients dissected (0.4%, 27/6,446 in native BAV and 11/2,232 in post-AVR). These are some survival curves from various studies
ncbi.nlm.nih.gov/pubmed/28490615

Summary. Post your favorite study on BAV aortopathy here. A thread for discussion. See poll below. #ACCFIT #MedEd #cardiotwitter #FOAMed @AmrFBarakat @Dr_DanMD @rajdoc2005
@EmilyGuhl @mhammadah @heatherlgornik @IbrahimMSaeed1 @jelevenson @jameschilee @leilii @vass_vassiliou

In isolated aortic root/ascending aortic aneurysm in a patient with BAV (no severe valve dysfunction), we offer surgery at a diameter (ignore indexing for now):
@venkmurthy @onco_cardiology @iamritu @almasthela @wikimagen @purviparwani @MarkELindsay @keaglemd @cshenoy3

@mariovar55 @GARCIAEDINSON95 @VLSorrellImages @DavidWienerMD @msenussiMD @PushpaShivaram @AChoiHeart @NadeenFaza @ChamsiPash @MusaSharkawi @RezaEmaminia @ash71us @dr_adeebq @AlsidawiMD @AkhilNarangMD @ecocardio_cl @SBarrosGomes @bcostelloMD @GBarnesMD @malamo512 @DocStrom