Abstract
It is correct that the bicuspid aortic valve is associated with aortic dilatation in a relevant proportion of individuals. It appears overly simplistic to relate the aortopathy to flow turbulence; genetic factors seem to play a more dominant role [2]. We do agree that aortic dilatation, if present, requires correction, as we have previously pointed out [3]. It seems very hypothetical that a very liberal use of vascular grafts results in improved event-free survival. This will have to be carefully studied first, weighing risks and benefits. Plication of prolapsing cusps is only one of several possible techniques [4]. On the other hand, we have found it to be simple, reproducible and durable [5]. In summary, we appreciate interest and comments in this new and growing area of cardiac surgery.
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