Introduction
Bicuspid aortic valve (BAV) is the most frequent congenital cardiac
anomaly, with a prevalence of 1-2%1 in the general
population. Aortic valve dysfunction and thoracic aortic disease are the
most common complications associated with BAV. Within thoracic aortic
aneurysms in BAV patients, supra-coronary aneurysm is the prevalent
phenotype (60-70% of dilatated aortas)2,3. In
patients with normal functioning BAV and supracoronary ascending aorta
aneurysm the 2017 European Guidelines4 advise for
isolated ascending aorta replacement , and two recent studies confirm
good long-term function of the BAV 5,6,7. However, in
patients undergoing supracoronary ascending aorta replacement with
concomitant mild-to moderate BAV diseases, the indication to aortic
valve replacement (AVR) is still a matter of debate. The aim of this
study is to assess the long-term evolution of untreated mild and
moderate BAV disease after isolated ascending aortic replacement.