December 2011 Update

Dear Colleagues:

I am pleased to inform you of our new website for the Thoracic Aneurysm and Bicuspid Aortic Valve Program at www.ValleyHeartandVascular.com/TABAV. The content reflects our clinical algorithms, with a focus on factors known to adversely affect risk. The site is meant to be an educational portal for both patients and health care providers.

Though it is well known that patients with large (>5.5cm) thoracic aneurysms generally have a higher risk of dissection or rupture, the best data in the world (1) describe that a small minority of smaller or modest-sized aneurysms may also carry a higher-than-expected risk of these complications. This is likely related to known and yet-unknown genetic risks that may not relate only to the aortic size. One genetically triggered aneurysm condition is related to a very common (1/50 in the U.S.) birth anomaly of the heart called Bicuspid Aortic Valve (BAV). These patients tend to experience adverse aortic events at smaller sizes, and one of the features of our website is an automatic 'relative aortic size' calculator (compares aneurysm size to body size), a concept that has been incorporated into the current 2010 AHA/ACC guidelines for the management of thoracic aortic diseases.

Our own data from The Valley Hospital shows that relative aortic size may be particularly relevant for women, and we hope to present this data at a national meeting in 2012. We have also developed unique research to try to better understand aneurysm risk independent of absolute aortic size alone. Our website describes our experimental model of aortic dissection, with the ultimate goal of being able to predict aortic stiffness (or breaking pressure) from specialized imaging studies. The site is comprehensive with respect to both thoracic aneurysm and bicuspid aortic valve, and many patients we meet are interested in a web-based reference tool to help them learn about their disease. Our content is original, unlike other sites which mirror information that may be somewhat outdated. Finally, the site contains some surgical videos that may be of interest to you. We will continue to update the content regularly and welcome your feedback. We hope you and your patients will find this to be a useful resource. Enclosed please find a brochure with more information on our program.

1. Pape LA, Tsai TT, Isselbacher EM, et. al. Aortic Diameter > 5.5 cm Is Not a Good Predictor of Type A Aortic Dissection. Observations From the International registry of Acute Aortic Dissection (IRAD) Circulation 2007;
116:1120-1127