For more than two decades, advanced practice providers at the Penn Surveillance Clinic have monitored and counseled patients with bicuspid aortic valve (BAV) disease. A congenital disorder, BAV is associated with the connective tissue syndromes and in these and other affected populations is a leading cause of irreversible aortic root dilation, aneurysm, rupture, and dissection. Affiliated with the Center for Bicuspid Aortic Valve Diseases at Penn Medicine, the APP-led Surveillance Clinic follows patients as they progress from dilation to aneurysm to monitor the size of their aortic diameter via imaging, adjust treatment plans, and, when needed, prepare patients for surgery and recovery.