The aortic valve, which separates the heart from the rest of the body, normally has three flaps, or leaflets, that open to let blood flow out to the heart and then close to prevent blood from leaking backward into the heart from the aorta. A bicuspid aortic valve has only two leaflets.

If you have a bicuspid aortic valve, you may develop a narrowed or leaky aortic valve, but this may not occur until adulthood. A narrowed valve may make it difficult for blood to flow through the valve, and the heart has to work harder to pump blood through a narrowed valve. In other cases, the valve may leak so that blood goes backward from the aorta into the heart. Over time, this can cause the heart to enlarge and work harder to compensate for the leaking valve.

In many people with a bicuspid aortic valve, the aorta is also abnormal and may enlarge or stretch out over time, putting them at risk for aortic aneurysms and rupture. If left untreated, this may eventually be life-threatening.

Causes

A bicuspid aortic valve is a congenital heart defect that occurs during fetal development. This heart defect may occur more commonly in some families. If bicuspid aortic valve runs in your family, you may want to have genetic testing.

Bicuspid Aortic Valve Symptoms

Symptoms of bicuspid aortic valve include fatigue, and the first indication you have bicuspid aortic valve may be a heart murmur.

Treatments

Medications

Medications cannot treat a bicuspid aortic valve. However, your physician may prescribe certain medications such as beta-blockers or angiotensin receptor blockers (ARBs) to slow the progression of aortic enlargement.

Nonsurgical procedures

Balloon valvuloplasty (valvotomy) is a nonsurgical procedure to treat some cases of bicuspid aortic valve.

Surgical procedures

Aortic valve replacement may be necessary for bicuspid aortic valves that have become severely narrowed or leak severely. Surgery may also be necessary if the aorta has gotten too large, regardless of the amount of valve narrowing or leakage.

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