Bicuspid Aortic Valve Treatments
Like many diseases, bicuspid aortic valve (BAV) will affect each patient differently. We take care to ensure our team of cardiologists, cardiac surgeons, nurses, rehabilitation specialists, psychologists and social workers work together to tailor a treatment plan specific to your needs.Once you are diagnosed, your treatment options depend on whether or not you have symptoms.
If you have no symptoms
Medical management is used to treat most people with BAV who do not have symptoms. Medical management can help:
- Slow the onset of complications
- Prevent further complications
- Recognize the onset of symptoms
- Identify optimal timing of surgical intervention
The goal of medical management of BAV is to achieve optimal blood pressure, heart rate and cholesterol levels. You and your cardiologist will decide if and when medications are necessary.You can also help manage your BAV by being heart healthy. Ways to be heart healthy include following a low fat, low sodium diet, being physically active, practicing good dental hygiene and quitting or avoiding smoking.
If you have symptoms
While medical management of your BAV will continue, once your aortic valve starts to leak or does not open completely, surgery may be your best treatment option.
Sometimes cardiac surgeons are able to fix BAV by performing an aortic valve repair. However, if the aortic valve is too damaged to repair, an aortic valve replacement may be the best option. You may also require surgery to repair or replace sections of your aorta. When it is determined that surgery is needed your cardiac surgeon will discuss which option(s) is best for your particular needs.
Surgical interventions for patients with complications related to BAV include:
- Aortic valve repair or replacement for patients with severe aortic stenosis or aortic insufficiency/regurgitation, in those patients having symptoms, and/or those with evidence of abnormal left ventricular function
- Minimally-invasive aortic valve replacement: Aortic valve replacement through a smaller “keyhole” incision
- Modified Bentall procedure: Replacement of the entire aortic root including the aortic valve and abnormal aortic wall
- David procedure: Valve-sparing aortic root replacement (aortic root replacement where one’s own aortic valve is spared but the abnormal aortic wall is replaced)
- Ross procedure: A diseased aortic valve is replaced with a person’s own pulmonary valve]
- Repair of the aorta: The diseased portion of aorta is removed and replaced with a synthetic (man-made) graft
Even after surgical repair or replacement of the BAV, you may still be at risk for future complications. We will give you a pre-discharge echocardiogram (ECHO) to establish your clinical baseline after surgery. Your physician will contact you three to six months after surgery to monitor your symptoms and progress. Seeing your cardiologist yearly for a check-up will help to determine if additional testing is required.
It is important to keep all appointments for blood work, tests and physician exams. Your cardiologist will make future medication changes and provide refills as needed. Talk with your physician about cardiac rehabilitation or routine exercise programs and the limitations on them depending on your condition.