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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Updated: Jun 27, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Published on: May 21, 2017

Risk of Aortic Root Rupture in Bicuspid Aortic Stenosis: The ABC Sizing Algorithm for SAPIEN 3 Valves.

Tej Sheth1, Josep Rodes Cabau2, Karl Poon3

  • 1Division of Cardiology, Hamilton Health Sciences and McMaster University, Canada (T.S., J.V., M.S.).

Circulation. Cardiovascular Interventions
|June 25, 2026
PubMed
Summary
This summary is machine-generated.

The ABC Bicuspid Sizing Algorithm effectively predicts aortic root rupture in patients undergoing transcatheter aortic valve replacement with SAPIEN 3 valves. High calcium volume, narrow sinus dimensions, and oversizing are key risk factors identified by the algorithm.

Keywords:
algorithmscalciumhumansodds ratiorisk assessment

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Area of Science:

  • Cardiology
  • Medical Imaging
  • Surgical Innovation

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic valve stenosis.
  • Bicuspid aortic valve anatomy presents unique challenges in TAVR sizing and risk assessment.
  • Aortic root rupture is a rare but serious complication following TAVR.

Purpose of the Study:

  • To evaluate the predictive accuracy of the ABC Bicuspid Sizing Algorithm for aortic root rupture.
  • To identify specific anatomical and sizing criteria associated with rupture risk.
  • To assess the algorithm's utility in stratifying risk for patients with bicuspid aortic valves undergoing TAVR.

Main Methods:

  • Retrospective multicenter study involving 170 patients (23 rupture cases, 147 controls) across 15 centers.
  • Computed tomography (CT) analysis performed blinded to rupture status.
  • Application of the ABC algorithm with defined high-risk criteria including oversizing, intercommissural distance, and calcium volume/distribution.

Main Results:

  • Patients with rupture had significantly higher total calcium volume, smaller intercommissural distance difference, smaller maximum sinus difference, and greater annular oversizing.
  • The ABC algorithm demonstrated high sensitivity (100%) and specificity (89.1%) in identifying rupture cases.
  • High diagnostic odds ratio (374.5) and positive likelihood ratio (9.19) indicate strong predictive power.

Conclusions:

  • High calcium volume, narrow sinus dimensions, and excessive valve oversizing are significantly associated with aortic root rupture.
  • The ABC algorithm shows promising performance for risk stratification in bicuspid aortic valve patients undergoing TAVR with SAPIEN 3 valves.
  • The algorithm aids in identifying patients at higher risk for aortic root rupture, potentially guiding procedural decisions.