Bicuspid Aortic Valve Disease

The two main types of bicuspid aortic valve disease are stenosis (when the opening to your valve becomes narrow or stiff) and regurgitation (when your valve doesn’t close completely and leaks). Often, the symptoms are barely noticeable — if at all. You might feel tired or lightheaded. If the disease if farther along, you might have chest pain, shortness of breath or feel dizzy.

At your appointment, your healthcare provider will take a detailed medical history and family medical history and will want to know all of your symptoms. Your provider may also listen to your heart through a stethoscope. If your provider hears a murmur (unusual whooshing sounds), that might mean there’s a blood flow problem in one of your valves. Not all murmurs are something to worry about, but it’s important to find out what’s causing the murmur and to check on it over time.

If you have a heart murmur and/or any of the symptoms mentioned above, your provider may order one or more tests to confirm a diagnosis. These tests may include echocardiography (heart ultrasound), transesophageal echocardiography (up-close heart ultrasound through your esophagus), a CT scan and an MRI to check how well your heart’s valves are working.

Other tests may include an electrocardiogram or EKG (to test your heart’s electrical activity), or coronary angiography (an X-ray of your heart’s blood vessels using a special dye). Your provider may also check you for aortic aneurysm, coronary artery disease and heart rhythm disorders.

Meet our bicuspid aortic valve disease team

At Cleveland Clinic, your care team will include world-renowned heart specialists. Each of these experts works together and with you to make sure you get exceptional care. Your team may include:

• Cardiologists.
• Cardiothoracic surgeons.
• Anesthesiologists.
• Pathologists.
• Nurses.

Your treatment will depend on the type of bicuspid aortic valve disease you have, how badly your valve is damaged, your age, medical history and your family medical history. But it will also depend on your goals — what you want to achieve with treatment. If you don’t have any symptoms or your symptoms are mild, your healthcare provider may simply keep an eye on your condition with regular checkups and repeated testing. If your condition is more serious, treatment options may include:

Medication

Heart valve disease is a mechanical problem. Picture the valves of your heart like plumbing in your house. If the valve in your sink doesn’t control water flow, it’ll eventually need to be replaced with a new part. This means that medicines can help but won’t fix the problem. Some medicines, though, such as diuretics (water pills), beta-blockers or anticoagulants (blood thinners), can relieve mild symptoms, help your heart pump better and lessen the chance of more valve damage.

Transcatheter aortic valve replacement (TAVR)

TAVR is a minimally invasive procedure that replaces your aortic valve using a small tube (catheter) that’s put into an artery in your groin or neck instead of making a large incision (cut) in your chest. Your provider will tell you if TAVR is an option for you.

Surgery

Most people with bicuspid aortic valve disease need surgery to repair or replace their valve. A repair can usually be done through a minimally invasive procedure to reshape your valve’s flaps so they open and close more completely. If a repair isn’t possible, your provider will decide if the valve needs to be replaced with a biological valve (from a cow or a pig) or mechanical valve (made from carbon and metal).

Traveling for Heart Care at Cleveland Clinic

We know that traveling for any kind of healthcare can be stressful and intimidating. If you’re coming to us from another city, state or even another country, we’re here to help make things as easy and convenient as possible for you. From knowing where to stay and where to eat, how to get to and from the airport, shop, or just find your way around any of our hospitals, we’re here for you.

If you’re an international patient, our experienced and compassionate Global Patient Services (GPS) team will help you navigate the Cleveland Clinic health system. They’ll connect you with the healthcare providers you need, help make appointments, provide language translation services and coordinate follow-up care when you return home.

Taking the Next Step

Learning that you may need treatment to repair or replace a part of your heart can be stressful. At Cleveland Clinic, our cardiologists and cardiothoracic surgeons are among the best in the world. They’re also compassionate providers who’ll help relieve your anxiety and be there for you throughout your journey with bicuspid aortic heart valve disease.