American Board of Internal Medicine (ABIM) Certification Practice Exam 2025 - Free ABIM Practice Questions and Study Guide

The recommended aortic diameter threshold for repair in patients with a bicuspid aortic valve is greater than 5.0 cm with increased risk. Bicuspid aortic valve disease is associated with a higher incidence of aortic dilation and dissection when compared to the general population with trileaflet aortic valves.

In patients with a bicuspid aortic valve, the aorta tends to enlarge more rapidly, and aortic surgery is generally indicated at a smaller diameter threshold due to this increased risk of complications. While guidelines typically suggest a threshold of 5.5 cm for the general population, in patients with a bicuspid valve, the greater risk necessitates intervention often at 5.0 cm or less, particularly if there are other risk factors such as a family history of aortic dissection or rapid aortic growth over time.

This approach helps to prevent potentially life-threatening incidents, such as aortic dissection, which can occur even at diameters lower than what is typically indicated for repair in individuals with a normal aortic valve. Therefore, monitoring and potentially opting for surgical intervention at the 5.0 cm threshold reflects the need for a proactive strategy in managing the risks associated with bicuspid aortic