There is very little evidence to suggest that bicuspid aortic valve patients need different treatment than patients with a "normal" aortic valve. The studies that indicate that the risk of aortic dissection was higher in bicuspid aortic valve patients were old, autopsy studies that definitely provide a bias view on the subject. There are numerous studies in patients who were followed and the growth of their ascending aorta was measured and clinical outcomes were measured. There was either no aortic dissection or other aortic complications during their follow-up. There will be a article coming out in the Annals of Thoracic Surgery from Dr. Griepp and the Mount Sinai Aortic Group in the next couple months related to this topic. Patients with bicuspid aortic valves can be followed carful before they may need surgery.