Does a 5.1 CM root aortic aneurysm with bicuspid valve require surgery

There are other factors that weigh into answering your question, body size, family history, other health issues, etc but in general after 5cm you start entering very high possibility of surgery. The bicuspid valve was likely a factor in the appearance of the aneurysm in the first place and they are known to deteriorate to the point that at some point they need to be replaced.

In my case I had both, my aneurysm was 5.2cm. I was in very good physical health and shape and my surgeon and cardiologist recommended I had it repaired (there was family history of ruptured aneurysms), it was large for my body size and being in good health made the probability of issues during surgery very low.

Replacing the valve at the same time would depend on how well the valve looked and functioned, if it was still in good shape he would leave it as he said any artificial valve he used would not be better than a highly functional natural valve.

That ended up being the case, he repaired the aneurysm but left the valve (he told me once removed the aneurysm looked larger than the measurement, so good decision getting repaired quickly). I get the valve checked every year with an echo by my cardiologist, it has deteriorated very slowly so it will be a few years before it will need to be replaced but now that the aneurysm is not there the replacement would be done endovascularly.

Hope everything goes well for you!!

As a 2015 survivor of a full aortic dissection, I agree with absolutely everything Houston just said. He beat me to the punch. Peace.

I had aortic valve replacement, 5 cm aneurysm repair, and a Maze procedure in February 2024.

My valve was diagnosed in the summer of 1999 and my cardiologist thought I was at the point where it needed to be replaced

But it was the discussion about the aneurysm that sold me. I can’t remember the exact odds my surgeon told me of the aneurysm bursting, but it was something like one out of 100 every year.

If I thought if my odds of getting killed by a shark were one out of every 100 times I swam in the ocean I’d never go in the ocean again. So at that point, I said let’s do this as quickly as possible.