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welcome to the cardiovascular surgery series where i discuss the latest research in cardiovascular surgery from the mayo clinic in just two minutes i am dr juan cricianalo and i am a cardiac surgeon at the mayo clinic in rochester minnesota i will review today the article published in the journal of thoracic and cardiovascular surgery in 2019 it is entitled open hemiarch versus clamp ascending aorta replacement for a orthopathy during initial bicuspid aortic valve replacement the extent of the distal aortic resection at the time of ascending aorta replacement for aneurysms related to bicast pedioratic valve is controversial some surgeons advocate a hemiarch replacement while others recommend resection limited to the ascending aorta we reviewed 700 patients with dicaste aortic valve who had replacement of the ascending aorta 70 percent had replacement limited to the ascending aorta while 30 percent had ascending aorta and hemiarch replacement surgery was longer in the hemiarch group and