Fate of the Aortic Arch Following Surgery on Aortic Root and Ascending Aorta in Bicuspid Aortic Valve

The authors retrospectively evaluated the long-term fate of the aortic arch in 168 patients with bicuspid aortic valves who had undergone either ascending aortic (24%) or aortic root (76%) replacement.  At a median follow-up of 5.9 years, the mean aortic arch diameter went from 2.9 cm preoperatively to 3.0 cm at follow-up (p=ns).  The authors conclude that prophylactic arch replacement in this population is not indicated, and perhaps neither is long-term aortic surveillance.