Roberts WC, et al. - Researchers studied the characteristics of a large group of patients with a purely regurgitant congenitally bicuspid aortic valve (BAV) unassociated with active or healed infective endocarditis or with acute or healed aortic dissection, having undergone replacement of the BAV with or without concomitant resection of the ascending aorta. The age of the patients ranged from 21 to 86 years (median 50). A total of 52 (39%) of 133 patients had simultaneous resection of the ascending aorta; its frequency varied inversely with the degree of aortic regurgitation (AR). In adults in the Western World undergoing aortic valve replacement for AR, a commonly documented cause of pure AR was congenitally BAV, unassociated with either infective endocarditis or aortic dissection. A dilated ascending aorta was present in nearly half the patients, and half the time those resected were histologically abnormal.