Bicuspid aortic valve
Bicuspid aortic valve is the most common type of aortic valve abnormality occurring in about two percent of the population. Instead of the normal three leaflets or cusps, the bicuspid aortic valve has only two.
The aortic valve is the valve through which the blood travels from the left ventricle or the main pumping chamber of the heart into the aorta or the main vessel of the heart, and then to the rest of the body. The aortic valve has 3 leaflets; normally it is a tri-leaflet structure. A bicuspid valve, for whatever reason, there are only two leaflets. Most commonly, this is congenital in origin, that is, a person is born with this. Sometimes, because of prosthesis, the leaflets can become scarred and two leaflets may become confused, therefore resulting in a functional bicuspid valve.
In bicuspid aortic valve, there are only 2 leaflets instead of three and the valve leaflets are often thickened. This can result in obstruction of blood flow across the valve, a condition called aortic stenosis and/or valve leakage, a condition called aortic valve regurgitation. The natural course of bicuspid aortic valve varies widely. There can be severe aortic stenosis at birth, due to incomplete opening of the valve leaflets. Aortic stenosis can also develop during childhood, during adulthood, peaking around the fourth decade of life, or it may never develop. Aortic valve leakage (called aortic regurgitation or aortic insufficiency) is less common during early childhood but can also develop over time. The remainder of this section refers to patients with bicuspid aortic valve without aortic stenosis.
Bicuspid aortic valve is a condition that affects 1-2% of the population. It is more common in males than females. Usually, this defect does not produce problems, although there is the possibility that in later life it could begin to cause some symptoms of 'aortic stenosis'. About a third of people affected have quite normal function throughout their lives, while others suffer symptoms in varying degrees.
In many cases no treatment is needed, although a valve replacement may sometimes be necessary. Diagnostic investigations such as echocardiogram and electrocardiogram (ECG) will be required.