What is Bicuspid Aortic Valve Disease?
The aortic valve is situated at the beginning of a large artery called the aorta and prevents blood from travelling back towards the heart when it closes. In 99% of people, it is made up of 3 leaflets (tricuspid). In a small proportion of patients, the valve if bicuspid (made of two leaflets). The valve can function perfectly well for many years without any cause for consequence.
What Are The Concerns Associated With Bicuspid Aortic Valve?
Over time, a bicuspid aortic valve can degenerate and calcify causing an important condition called aortic stenosis. Patients who present with aortic stenosis in middle age often have bicuspid aortic valve disease. Once severe, the aortic valve needs to be replaced to avoid premature death.
In others, the bicuspid aortic valve regurgitates and starts to allow blood to leak back towards the heart causing heart failure. In this condition, the aortic valve can sometimes be repaired.
What Is The Association Between Bicuspid Aortic Valve And Aortic Aneurysm?
A high proportion of patients with bicuspid aortic valve disease have associated weakness in the wall of the aorta pipe which can start to swell and become aneurysmal. This is a dangerous condition which can result in tearing or rupture of the aorta. The treatment for this is to repair or replace the aortic valve as well as the enlarged aorta.
Aortic valve and ascending aorta will be replaced with bioprosthetic valve and synthetic vascular graft respectively. Cardiac surgeon inserting stitches that will keep valve and graft in place.
Can My Aortic Valve Be Repaired Rather Than Replaced?
Yes, in certain circumstances, the aortic valve can be preserved. In aortic regurgitation, certain features of the valve may lend itself better to repair than replacement. In situations where the aorta is also enlarged, it is even more likely that aortic valve preservation can be performed using a procedure called Aortic Valve Preserving Aortic Root Replacement (David Procedure).
What Is The Benefit Of Preserving My Bicuspid Valve?
If the aortic valve can be repaired and preserved, the long-term durability is often better than if we replaced the valve with a tissue valve made from pigs or cows. Repairing the valve also avoids the need for long term blood thinners which are a requirement with mechanical valves. One final benefit of repairing the aortic valve lies in the fact that the haemodynamic function is far better than in aortic valve replacement. This has been shown to offer long term benefits in term of recovery of the heart to normal function.
Can Bicuspid Valve Surgery Be Performed By Keyhole Heart Surgery?
Yes, if certain criteria are met, then the majority of patients can undergo surgery using minimally invasive surgery. This is beneficial in a number of ways including Less Pain, Less Bleeding, Less Infection, Swifter Healing, Better Cosmetic Results. Learn more here.
How Can I Find Out More About Treatment?
You can speak with your GP, your hospital cardiologist about your condition. You can also call us on 02080640535 to arrange an appointment with Mr Birdi or one of our other specialists at any time.
