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 Kovacs, E. Magnus Ohman, Susan Pressler, Frank W. Sellke, Win Kuang Shen, Duminda N. Wijeysundera

Research output: Contribution to journalArticle

26 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 E.; Curtis, Lesley H.; Fleisher, Lee A.; Gentile, Federico; Gidding, Samuel; Hlatky, Mark A.; Ikonomidis, John; Joglar, José; Kovacs, Richard; Ohman, E. Magnus; Pressler, Susan; 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, JE, Curtis, LH, Fleisher, LA, Gentile, F, Gidding, S, Hlatky, MA, Ikonomidis, J, Joglar, J, Kovacs, R, Ohman, EM, Pressler, S, 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 E. ; Curtis, Lesley H. ; Fleisher, Lee A. ; Gentile, Federico ; Gidding, Samuel ; Hlatky, Mark A. ; Ikonomidis, John ; Joglar, José ; Kovacs, Richard ; Ohman, E. Magnus ; Pressler, Susan ; 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{b120894f7f7649ee95557e9a5d1b9075,
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 Cigarroa, {Joaquin E.} 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 Richard Kovacs and Ohman, {E. Magnus} and Susan Pressler 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 E.

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

AU - Ohman, E. Magnus

AU - Pressler, Susan

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 -