Does preventive aortic surgery at the time of AVR prevent aortic dissection or rupture in patients with a dilated ascending aorta (40 to 50 mm)?
Preventive aortic surgery should be considered during AVR for patients with mild ascending aorta dilation (40-50 mm) to prevent future dissection or rupture.
Although the clinical course of patients with a dilated ascending aorta is unpredictable, aortic events may occur even in patients with a baseline aortic diameter of <50 mm. Therefore, preventive aortic surgery at the time of AVR should be considered to prevent aortic dissection or rupture in patients with an even slightly dilated ascending aorta with a diameter of 40 to 50 mm, unless the patient has a high operative risk or older age.
Matsuyama et al. (Sat,) studied this question.