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Bicuspid Aortic Valve

Bicuspid aortic valve is the most common type of aortic valve abnormality. It is found in about 1-2% of the population. It is a congenital heart defect (present at birth). The condition may go undetected, as it may not produce any heart murmur, just a clicking sound. In addition, up to 25% of family members may have a similar condition (or another type of heart defect). The valve may become thickened and stiff (aortic stenosis) producing an obstruction. On the other hand, the valve may not be able to close tightly resulting in leakage of blood back into the heart (aortic insufficiency or regurgitation). For this and other reasons, I usually recommend for the immediate family to undergo cardiovascular screening to be sure that other family members do not have the same or other heart defects.

About 2/3 of people have a well-functioning bicuspid aortic valve. Most patients remain asymptomatic unless they develop significant leakage or obstruction in the aortic valve.

 

A small percentage of patients with bicuspid aortic valve may have other heart defects. Dr. Villafañe will be able to look for any associated heart defects and if the bicuspid valve has any narrowing or leakage present. The cardiovascular evaluation will include a thorough physical exam, electrocardiogram and echocardiogram. Some patients may also require a chest x-ray and stress testing.

 

In many cases, patients with a bicuspid aortic valve do not require any intervention during childhood and there will be no need of activity restriction. There is a small potential risk for endocarditis (serious infection of the valve itself). For that reason you should follow optimal dental hygiene by brushing your teeth two or three times a day and flossing. Semi-annual dental appointments are also recommended. You should discuss with Dr. Villafañe the new recommendations from the American Heart Association to see if there is a need for the use of antibiotics before dental appointments or invasive procedures (SBE prophylaxis).

 

Patients with bicuspid aortic valve will need lifetime follow-up by a cardiologist.

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