Open AccessThreshold for intervention upon ascending aortic aneurysms: an evolving target and implication of bicuspid aortic valve
Author(s) -
Shinichi Fukuhara,
Michael Ibrahim,
Daniel-Sebastian Dohle,
Joseph E. Bavaria
Publication year - 2018
Publication title -
indian journal of thoracic and cardiovascular surgery/indian journal of thoracic and cardiovascular surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.114
H-Index - 9
eISSN - 0973-7723
pISSN - 0970-9134
DOI - 10.1007/s12055-018-0674-7
Subject(s) - bicuspid aortic valve , medicine , cardiothoracic surgery , cardiac surgery , asymptomatic , vascular surgery , cardiology , aortic aneurysm , aortic valve , thoracic aortic aneurysm , aneurysm , modalities , surgery , radiology , social science , sociology
With the proliferation of non-invasive thoracic imaging modalities, the question of when to operate on asymptomatic ascending aortic aneurysms for non-syndromic patients is becoming increasingly relevant. Operation is extensive, often involves circulatory arrest, and subjects the patient to significant risk of mortality and morbidity. Surgery is performed to avert fatal aortic adverse events, which carry a markedly poor prognosis. The question of when the balance is tipped toward preemptive surgical repair is challenging and is centered around predicting the risk of an acute aortic syndrome. Size of the aneurysm has been the traditional guide for decision-making but how this is measured, what risks it truly predicts, the influence of the patient's size, valve morphology, genetic profile, and other risk factors for non-syndromic patients are poorly understood. We here review this issue in detail.