I do have a question: In their introduction, the authors state that “Pathologic evidence has been used to support an alternative theory for aortic dilation, in which it is postulated that a genetic or developmental abnormality in the proximal aortic tissue leads to weakness of the aortic wall with a BAV” – rather than altered hemodynamics as an important factor in the etiology of ascending aortic dilatation. However, they do not refer to this topic again. Some of their images reveal not only a dilated ascending aorta, but also effacement of the STJ, which we know is associated to other aortic problems. Did patients with preserved STJ have normal-sized aortas? How did the flow vectors compare among patients with BAV and preserved versus effaced STJ?