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6.1.3. BAV Aortopathy
COR LOE
Recommendations
1 B-NR 1. In patients with a BAV, TTE is indicated to evaluate valve
morpholog y and function, to evaluate the diameter of the
aortic root and ascending aorta, and to evaluate for aortic
coarctation and other associated cardiovascular defects.
1 C-LD 2. In patients with a BAV, CT or MRI of the thoracic aorta is
indicated when the diameter and morpholog y of the aortic
root, ascending aorta, or both cannot be assessed accurately or
completely by TTE.
1 C-LD 3. In patients with a BAV and either HTAD or phenotypic
features concerning for Loeys-Dietz syndrome, a medical
genetics evaluation is recommended.
1 C-LD 4. In patients with a BAV and a dilated aortic root or ascending
aorta, screening of all first-degree relatives by TTE is
recommended to evaluate for the presence of a BAV, dilation
of the aortic root and ascending aorta, or both; if the diameter
and morpholog y of the aortic root, ascending aorta, or both
cannot be assessed accurately or completely by TTE, a cardiac-
gated CT or MRI of the thoracic aorta is indicated.
2a B-NR 5. In patients with a BAV, screening of all first-degree relatives
by TTE is reasonable to evaluate for the presence of a BAV,
dilation of the aortic root and ascending aorta, or both.
6.1.3.1. Routine Follow-Up of BAV Disease Aortopathy
COR LOE
Recommendations
1 B-NR 1. In patients with a BAV who have undergone previous aortic
valve repair or replacement and have a diameter of the
aortic root, ascending aortic, or both of ≥4.0 cm, lifelong
surveillance imaging of the aortic root and ascending aorta by
TTE, CT, or MRI is recommended at an interval dependent
on aortic diameter and rate of growth.
1 C-LD 2. In patients with a BAV and a diameter of the aortic root,
ascending aorta, or both of ≥4.0 cm, lifelong surveillance
imaging of the aortic root and ascending aorta by TTE, CT,
or MRI is recommended at an interval dependent on aortic
diameter and rate of growth.
