Bicuspid-aortic valve surgery: repair or replace?

PURPOSE OF REVIEW: The surgical management of the bicuspid-aortic valve along with associated aortic disease remains a challenge. On the basis of recent literature as well as on our own experience, we offer several recommendations for the most appropriate surgical management of the patients with bicuspid-aortic valve disease.

RECENT FINDINGS: In 2006, the American College of Cardiology and the American Heart Association published guidelines in order to define the standard of care for the management of patients with bicuspid-aortic valve; however, these are consensus-based, mainly from observational studies, and not all surgeons accept these recommendations.

SUMMARY: Surgery for bicuspid-aortic valve and associated aortic disease should be 'custom-made' for each patient and may require complex decision-making.