Table 7.

Comparison of national guidelines for the management of TAA in patients with Marfan syndrome.

Canadian Cardiovascular Society 2009 Consensus	Japanese Circulation Society 2011 guidelines	ESC 2010
The following situations warrant surgical intervention: •A maximal aortic root/ascending aorta diameter of greater than 50 mm. • A maximal aortic root/ascending aorta diameter of greater than 45 mm to 50 mm with the following: 1 Rapid aortic root growth of more than 5 mm per year. 2 Progressive aortic regurgitation, especially if the surgeon believes the aortic valve can be spared and an aortic valve-sparing procedure is planned. 3 Family history of premature aortic dissection of less than 50 mm. 4 Severe mitral valve regurgitation that requires surgery. •A maximal aortic root/ascending aorta diameter of greater than 44 mm if pregnancy is desired. •A maximal dimension of other parts of the aorta of 50 mm to 60 mm or progressive dilation. •Severe mitral regurgitation with symptoms or progressive LV dilation/dysfunction as per the current guidelines on valvular heart disease.	The following situations warrant surgical intervention: •Aortic root replacement when aortic root diameter exceeds 45 mm •Aortic root replacement in an individual with a history or family history of dissection when aortic root diameter is 40 mm or greater •Aortic root replacement in women contemplating pregnancy when aortic root diameter is 40 mm or greater	The following situations warrant surgical intervention: •Ascending aorta diameter greater than 50 mm. Consider surgery if greater than 45 mm. • Ascending aorta diameter between 46 and 50 mm with: 1 Family history of dissection 2 Progressive dilation of more than 2 mm per year as confirmed by repeated measurements 3 Severe AR or MR 4 Desire of pregnancy •Patients should be considered for surgery if other parts of the aorta are over 50 mm.
(Silversides, Kiess et al., 2010) [45]	(Group 2013)	(Baumgartner, Bonhoeffer et al., 2010) [46]