Surgery for aortic dilatation in patients with bicuspid aortic valves: A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Loren F. Hiratzka, Mark A. Creager, Eric M. Isselbacher, Lars G. Svensson, Rick A. Nishimura, Robert O. Bonow, Robert A. Guyton, Thoralf M. Sundt, Jonathan L. Halperin, Glenn N. Levine, Jeffrey L. Anderson, Nancy M. Albert, Sana M. Al-Khatib, Kim K. Birtcher, Biykem Bozkurt, Ralph G. Brindis, Joaquin Cigarroa, Lesley H. Curtis, Lee A. Fleisher, Federico GentileSamuel Gidding, Mark A. Hlatky, John Ikonomidis, José Joglar, Richard J. Kovacs, E. Magnus Ohman, Susan J. Pressler, Frank W. Sellke, Win Kuang Shen, Duminda N. Wijeysundera

    Research output: Contribution to journalArticle

    28 Citations (Scopus)

    Abstract

    Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (Circulation. 2010;121:e266-e369) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (Circulation. 2014;129:e521-e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.

    Original languageEnglish (US)
    Pages (from-to)680-686
    Number of pages7
    JournalCirculation
    Volume133
    Issue number7
    DOIs
    StatePublished - Feb 16 2016

    Fingerprint

    Advisory Committees
    Practice Guidelines
    Dilatation
    Guidelines
    American Heart Association
    Cardiology
    Thoracic Diseases
    Aortic Diseases
    Heart Valve Diseases
    Bicuspid Aortic Valve
    Dissection

    Keywords

    • AHA Scientific Statements
    • anticoagulation therapy
    • heart valves
    • thoracic aortic aneurysm
    • thoracic aortic disease
    • thoracic aortic dissection
    • valvular heart disease

    ASJC Scopus subject areas

    • Physiology (medical)
    • Cardiology and Cardiovascular Medicine

    Cite this

    Surgery for aortic dilatation in patients with bicuspid aortic valves : A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. / Hiratzka, Loren F.; Creager, Mark A.; Isselbacher, Eric M.; Svensson, Lars G.; Nishimura, Rick A.; Bonow, Robert O.; Guyton, Robert A.; Sundt, Thoralf M.; Halperin, Jonathan L.; Levine, Glenn N.; Anderson, Jeffrey L.; Albert, Nancy M.; Al-Khatib, Sana M.; Birtcher, Kim K.; Bozkurt, Biykem; Brindis, Ralph G.; Cigarroa, Joaquin; Curtis, Lesley H.; Fleisher, Lee A.; Gentile, Federico; Gidding, Samuel; Hlatky, Mark A.; Ikonomidis, John; Joglar, José; Kovacs, Richard J.; Ohman, E. Magnus; Pressler, Susan J.; Sellke, Frank W.; Shen, Win Kuang; Wijeysundera, Duminda N.

    In: Circulation, Vol. 133, No. 7, 16.02.2016, p. 680-686.

    Research output: Contribution to journalArticle

    Hiratzka, LF, Creager, MA, Isselbacher, EM, Svensson, LG, Nishimura, RA, Bonow, RO, Guyton, RA, Sundt, TM, Halperin, JL, Levine, GN, Anderson, JL, Albert, NM, Al-Khatib, SM, Birtcher, KK, Bozkurt, B, Brindis, RG, Cigarroa, J, Curtis, LH, Fleisher, LA, Gentile, F, Gidding, S, Hlatky, MA, Ikonomidis, J, Joglar, J, Kovacs, RJ, Ohman, EM, Pressler, SJ, Sellke, FW, Shen, WK & Wijeysundera, DN 2016, 'Surgery for aortic dilatation in patients with bicuspid aortic valves: A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines', Circulation, vol. 133, no. 7, pp. 680-686. https://doi.org/10.1161/CIR.0000000000000331
    Hiratzka, Loren F. ; Creager, Mark A. ; Isselbacher, Eric M. ; Svensson, Lars G. ; Nishimura, Rick A. ; Bonow, Robert O. ; Guyton, Robert A. ; Sundt, Thoralf M. ; Halperin, Jonathan L. ; Levine, Glenn N. ; Anderson, Jeffrey L. ; Albert, Nancy M. ; Al-Khatib, Sana M. ; Birtcher, Kim K. ; Bozkurt, Biykem ; Brindis, Ralph G. ; Cigarroa, Joaquin ; Curtis, Lesley H. ; Fleisher, Lee A. ; Gentile, Federico ; Gidding, Samuel ; Hlatky, Mark A. ; Ikonomidis, John ; Joglar, José ; Kovacs, Richard J. ; Ohman, E. Magnus ; Pressler, Susan J. ; Sellke, Frank W. ; Shen, Win Kuang ; Wijeysundera, Duminda N. / Surgery for aortic dilatation in patients with bicuspid aortic valves : A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. In: Circulation. 2016 ; Vol. 133, No. 7. pp. 680-686.
    @article{2df7f634eb704051ab503be68918c86a,
    title = "Surgery for aortic dilatation in patients with bicuspid aortic valves: A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines",
    abstract = "Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the {"}2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease{"} (Circulation. 2010;121:e266-e369) and the {"}2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease{"} (Circulation. 2014;129:e521-e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.",
    keywords = "AHA Scientific Statements, anticoagulation therapy, heart valves, thoracic aortic aneurysm, thoracic aortic disease, thoracic aortic dissection, valvular heart disease",
    author = "Hiratzka, {Loren F.} and Creager, {Mark A.} and Isselbacher, {Eric M.} and Svensson, {Lars G.} and Nishimura, {Rick A.} and Bonow, {Robert O.} and Guyton, {Robert A.} and Sundt, {Thoralf M.} and Halperin, {Jonathan L.} and Levine, {Glenn N.} and Anderson, {Jeffrey L.} and Albert, {Nancy M.} and Al-Khatib, {Sana M.} and Birtcher, {Kim K.} and Biykem Bozkurt and Brindis, {Ralph G.} and Joaquin Cigarroa and Curtis, {Lesley H.} and Fleisher, {Lee A.} and Federico Gentile and Samuel Gidding and Hlatky, {Mark A.} and John Ikonomidis and Jos{\'e} Joglar and Kovacs, {Richard J.} and Ohman, {E. Magnus} and Pressler, {Susan J.} and Sellke, {Frank W.} and Shen, {Win Kuang} and Wijeysundera, {Duminda N.}",
    year = "2016",
    month = "2",
    day = "16",
    doi = "10.1161/CIR.0000000000000331",
    language = "English (US)",
    volume = "133",
    pages = "680--686",
    journal = "Circulation",
    issn = "0009-7322",
    publisher = "Lippincott Williams and Wilkins",
    number = "7",

    }

    TY - JOUR

    T1 - Surgery for aortic dilatation in patients with bicuspid aortic valves

    T2 - A statement of clarification from the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

    AU - Hiratzka, Loren F.

    AU - Creager, Mark A.

    AU - Isselbacher, Eric M.

    AU - Svensson, Lars G.

    AU - Nishimura, Rick A.

    AU - Bonow, Robert O.

    AU - Guyton, Robert A.

    AU - Sundt, Thoralf M.

    AU - Halperin, Jonathan L.

    AU - Levine, Glenn N.

    AU - Anderson, Jeffrey L.

    AU - Albert, Nancy M.

    AU - Al-Khatib, Sana M.

    AU - Birtcher, Kim K.

    AU - Bozkurt, Biykem

    AU - Brindis, Ralph G.

    AU - Cigarroa, Joaquin

    AU - Curtis, Lesley H.

    AU - Fleisher, Lee A.

    AU - Gentile, Federico

    AU - Gidding, Samuel

    AU - Hlatky, Mark A.

    AU - Ikonomidis, John

    AU - Joglar, José

    AU - Kovacs, Richard J.

    AU - Ohman, E. Magnus

    AU - Pressler, Susan J.

    AU - Sellke, Frank W.

    AU - Shen, Win Kuang

    AU - Wijeysundera, Duminda N.

    PY - 2016/2/16

    Y1 - 2016/2/16

    N2 - Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (Circulation. 2010;121:e266-e369) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (Circulation. 2014;129:e521-e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.

    AB - Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (Circulation. 2010;121:e266-e369) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (Circulation. 2014;129:e521-e643). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.

    KW - AHA Scientific Statements

    KW - anticoagulation therapy

    KW - heart valves

    KW - thoracic aortic aneurysm

    KW - thoracic aortic disease

    KW - thoracic aortic dissection

    KW - valvular heart disease

    UR - http://www.scopus.com/inward/record.url?scp=84959018702&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84959018702&partnerID=8YFLogxK

    U2 - 10.1161/CIR.0000000000000331

    DO - 10.1161/CIR.0000000000000331

    M3 - Article

    C2 - 26637530

    AN - SCOPUS:84959018702

    VL - 133

    SP - 680

    EP - 686

    JO - Circulation

    JF - Circulation

    SN - 0009-7322

    IS - 7

    ER -