. Author manuscript; available in PMC: 2019 Feb 21.

Published in final edited form as: J Thorac Cardiovasc Surg. 2018 Aug;156(2):473–480. doi: 10.1016/j.jtcvs.2017.10.161

TABLE 1.

Recommendations for initial imaging of the aorta in patients with bicuspid aortic valve

Recommendation	Class/LOE
TTE is the initial imaging modality of choice for assessment of the aortic valve and thoracic aorta in patients with BAV.	I/C^3,18
The entire thoracic aorta should be measured by TTE, reporting each aortic segment separately in millimeters: root (sinuses of Valsalva), sinotubular junction, tubular ascending aorta (proximal, mid and distal), arch and descending thoracic aorta. Maximum diameter, regardless of location, should be reported. Aortic coarctation should be ruled out with Doppler evaluation of the descending thoracic aorta and abdominal aorta.	I/C^3,5,18
If TTE cannot visualize any aortic segment or any segment measures ≥45 mm or aortic coarctation cannot be ruled out, recommend assessment of the entire thoracic aorta with ECG-gated cardiac MRA or CTA.	I/C^19,20
If a patient is undergoing cardiac surgery and root or tubular ascending aorta measure 40–44 mm by TTE, recommend assessment of the thoracic aorta with MRA or CTA before surgery.	I/C^17,19,20
If aortic coarctation is present, screening for cerebral aneurysms is recommended.	I/B⁵

LOE, Level of evidence; TTE, transthoracic echocardiography; BAV, bicuspid aortic valve; ECG, electrocardiogram; MRA, magnetic resonance angiography; CTA, computed tomography angiography.