This study aims to determine the relationship between the cross-sectional aortic area/patient height ratio (indexed aortic area) and absolute aortic diameter in proximal thoracic aortic aneurysms associated with a bicuspid valve. This will shed light on whether aneurysms with smaller diameters than those recommended for surgical intervention by guidelines are still at risk of aortic complications attending an abnormally high indexed aortic area.

Inclusion Criteria:

• Age >18 years
• First-time surgery
• Bicuspid aortic valve confirmed
• Thoracic aortic aneurysm involving aortic root or ascending aorta

Exclusion Criteria:

• No available pre-operative cross-sectional imaging
• Re-do surgery

All consecutive adult patients undergoing first-time surgery for a BAV-related aneurysm involving the aortic root and/or ascending aorta, between 2010-2016 at our institution