Recommendations for BAV Aortopathy Interventions: Replacement of the Aorta in Patients With BAV

Referenced studies that support the recommendations are summarized in the Online Data Supplement.

COR	LOE	RECOMMENDATIONS
1	B-NR	1. In patients with a BAV and a diameter of the aortic root, ascending aorta, or both of ≥5.5 cm, surgery to replace the aortic root, ascending aorta, or both is recommended.1–3
2a	B-NR	2. In patients with a BAV and a cross-sectional aortic root or ascending aortic area (cm2) to height (m) ratio of ≥10 cm2/m, surgery to replace the aortic root, ascending aorta, or both is reasonable, when performed by experienced surgeons in a Multidisciplinary Aortic Team.3,4
2a	B-NR	3. In patients with a BAV, a diameter of the aortic root or ascending aorta of 5.0 cm to 5.4 cm, and an additional risk factor for aortic dissection (Table 14), surgery to replace the aortic root, ascending aorta, or both is reasonable, when performed by experienced surgeons in a Multidisciplinary Aortic Team.1,5
2a	B-NR	4. In patients with a BAV who are undergoing surgical aortic valve repair or replacement, and who have a diameter of the aortic root or ascending aorta of ≥4.5 cm, concomitant replacement of the aortic root, ascending aorta, or both is reasonable, when performed by experienced surgeons in a Multidisciplinary Aortic Team.1,6
2b	B-NR	5. In patients with a BAV, a diameter of the aortic root or ascending aorta of 5.0 cm to 5.4 cm, no other risk factors for aortic dissection (Table 14), and at low surgical risk, surgery to replace the aortic root, ascending aorta, or both may be reasonable, when performed by experienced surgeons in a Multidisciplinary Aortic Team.1,2,5