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Bicuspid Aortic Valve

Overview

Bicuspid aortic valve is a condition in which the aortic valve has only two leaflets — the tissue that opens and closes to start and stop blood flow through the heart — instead of three. The aortic valve regulates oxygen-rich blood flow from the heart to the aorta. It also prevents blood from flowing back into the heart. If the aortic valve has only two leaflets, complications may develop. The aortic valve may not be effective at stopping aortic regurgitation — which is blood leakage back into the heart. Aortic stenosis — when the aortic valve stiffens and does not open properly — may also occur, making the heart pump harder to move blood through the valve.

Bicuspid aortic valve is the most common congenital heart defect — a problem with the heart that is present at birth. However, a child with this condition may not experience symptoms or receive a diagnosis until adulthood.

  • Symptoms

    • Chest pain
    • Dizziness and fainting
    • Fatigue
    • Shortness of breath
  • Prevention

    This is an inherited condition and cannot be prevented.

  • Risk Factors

    • Abnormalities in development of the aorta before birth
    • Being male
    • Having a family member with the condition
    • Presence of a disease that blocks blood flow on the left side of the heart
  • Diagnosis

    Clinical evaluation. Your healthcare provider will look for signs of the condition, such as a heart murmur, enlarged heart and faint pulse in the wrists and ankles. To confirm a diagnosis, the provider will order tests to get a better look at the heart.

    Imaging tests. A heart MRI and echocardiogram are two common tests your provider may use to detect abnormalities. An MRI uses magnets and radio waves to provide a detailed image of the heart. An echocardiogram uses sound waves to generate pictures of the heart.

    Other tests. Your physician may rule out other complications with additional tests, such as a chest X-ray, electrocardiogram or cardiac catheterization.

  • Treatment

    • Drug treatment. Medications will not fix the aortic valve, but they may relieve symptoms. Your physician may prescribe a beta-blocker, a medication that treats numerous heart problems and relieves pressure on the heart. You may also be prescribed inotropic agents, a group of medications that make the heart pump harder.
    • Valve repair. Balloon valvuloplasty is a procedure often used to open a stiffened aortic valve. This is less invasive than open-heart surgery because there is no need to open the chest. The procedure is done by inserting a catheter intravenously through the groin and guiding it to the heart. A balloon is attached to the catheter and expands to open the aortic valve.
    • Valve replacement. Repairing the valve is often necessary for adults who have aortic valve stenosis or incompetence. Your provider will discuss with you about the type of valve replacement that works best for your own circumstances.
  • Follow-up Care

    If you undergo surgery for treatment, follow your healthcare provider's instructions for care.