should my aortic root be operated on at time of AVR.

Hi,I'm a 57 yr old male with a bicuspid aortic valve that now needs replacing because of both stenosis and incompetance.My surgery is scheduled for 26/2/09.My aortic root and ascending aorta is mildly dilated at 4cm.There is no other family history of BAV or aorta problems.I have read a lot about the condition BAV and the association with aneurism (aneurysm) and dissection.I am not keen to run the risk of further aortic problems when there may be an opportunity now to fix it at the time of my AVR.My surgeon doesn't believe it needs operating at 4cm only observing.I am otherwise fit apart from a non st elevation ACS 3 months ago from which I've recovered well.I'd appreciate another opinion.

[kenkeith]

Usually the assessment is whether or not the surgeon is able to save the AV when there is a dilated aorta greater than 5.0 cm and when there should be surgery for bicuspid valve syndrome.  The pattern for aorta root size is estimated to be 0.05 from 6 months to a year.  A 4.0 aorta root is considered an aneurysm, generally.

Does the surgeon comment if the aorta valve is replaced that will prevent the root from increasing in size?  

[Baz425]

Thanks for the comments.I will have an informed discussion with my surgeon in the next few weeks.I've read all I can regarding bicuspid aortic valve disease and its associated problems.It seems there are many different opinions regarding aortic surgery at the time of AVR in this condition.