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 E. 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

    29 Scopus citations

    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

    Keywords

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

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

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  • Cite this

    Hiratzka, L. F., Creager, M. A., Isselbacher, E. M., Svensson, L. G., Nishimura, R. A., Bonow, R. O., Guyton, R. A., Sundt, T. M., Halperin, J. L., Levine, G. N., Anderson, J. L., Albert, N. M., Al-Khatib, S. M., Birtcher, K. K., Bozkurt, B., Brindis, R. G., Cigarroa, J. E., Curtis, L. H., Fleisher, L. A., ... Wijeysundera, D. N. (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, 133(7), 680-686. https://doi.org/10.1161/CIR.0000000000000331