Bicuspid aortic valve

Diagnosis

A bicuspid aortic valve can be detected incidentally while conducting tests for other health concerns. A heart murmur may be heard during a routine examination. To confirm the diagnosis, an echocardiogram is used to create videos of the heart’s beating, showing blood flow through the heart chambers, valves, and the aorta. Additionally, a computed tomography (CT) scan is usually performed to check for any changes in the size of the aorta in individuals with a bicuspid aortic valve.

Treatment

Individuals with a bicuspid aortic valve are usually directed to a congenital cardiologist, specialized in congenital heart disease, for their healthcare needs. Regular checkups and imaging tests like echocardiograms are essential to assess the condition of the aortic valve for narrowing or leakage and to monitor any changes in the size of the aorta. Treatment approaches, which may involve medications, procedures, or surgery, depend on the severity of the heart valve disease.

Medications

While there are no medicines available to repair a bicuspid aortic valve itself, they can be utilized to manage symptoms caused by heart valve disease. For instance, blood pressure medicine might be recommended by your healthcare provider to address related issues.

Surgeries or other procedures

A bicuspid aortic valve may necessitate surgery if it is causing:

• Aortic valve stenosis.
• Aortic valve regurgitation.
• An enlarged aorta.

The aortic valve is surgically repaired or replaced. The precise heart valve issue and your symptoms will determine the sort of surgery that is performed.

• Aortic valve replacement. During the surgical procedure, the damaged valve is removed and substituted with either a mechanical valve or a biological tissue valve derived from cow, pig, or human heart tissue. In more complex cases, the aortic valve can be replaced with the patient’s own lung valve, which is then substituted with a lung tissue valve from a deceased donor, known as the Ross procedure. While biological tissue valves may degrade over time and require replacement, those with mechanical valves must take blood thinners indefinitely to prevent blood clots. The choice between valve types involves a thorough discussion between the patient and their healthcare provider, considering the associated benefits and risks of each option.
• Aortic root and ascending aorta surgery. During the procedure, surgeons remove the enlarged section of the aorta near the heart and replace it with a synthetic tube known as a graft, which is carefully sewn into position. In some cases, only the enlarged portion of the aorta is removed, leaving the aortic valve intact. Alternatively, the aortic valve can be either replaced or repaired during this surgical intervention.
• Balloon valvuloplasty. This heart valve procedure utilizes a thin and flexible tube known as a catheter with a balloon on its tip, making it an effective treatment for aortic valve stenosis in infants and children. However, in adults, the aortic valve often narrows again after the procedure, so it is typically reserved for those who are medically unfit to undergo surgery or are awaiting a valve replacement. During the process, the surgeon inserts the catheter into an artery in the arm or groin and guides it to the aortic valve. Once in position, the balloon on the catheter is inflated, enlarging the valve opening. Subsequently, the balloon is deflated, and both the catheter and balloon are removed.