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Ann Thorac Surg 2000;69:1337
© 2000 The Society of Thoracic Surgeons

Discussion

Discussion

DR MICHAEL J. REARDON (Houston, TX): This is a very nice paper. Of course it is fairly easy when you have a great big aorta to decide what to do. The interesting question is, how small do you go in replacing these aortas, what is your lower limit cutoff?

DR SUNDT: Doctor Kouchoukos taught me to replace an aorta that is greater than 4 cm in diameter in the presence of a bicuspid aortic valve. There are sufficient data in the literature that the risk of dissection following aortic valve replacement for bicuspid aortic valve is significantly greater, particularly when the aorta is greater than 5 cm in diameter. I replace aortas down to about 4 cm in diameter as a general rule, and have felt this is a reasonable practice.





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