Bicuspid Aortic Valve

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The healthy heart’s aortic valve has three flaps, called leaflets. The flaps open and close to allow blood to flow into the body. A bicuspid aortic valve only has two flaps, which may not close properly and cause blood to flow backward into the heart.

The UPMC Center for Thoracic Aortic Disease provides expert care for people living with bicuspid aortic valve disease. We offer the latest valve repair and replacement surgeries to treat your heart problem.

What Is a Bicuspid Aortic Valve?

Arteries carry blood away from the heart. The aortic valve is a one-way valve that connects the heart and the aorta, the body’s largest artery.

A normal aortic valve has three flaps (leaflets). They open and close to allow blood to flow out of the heart and into the aorta.

If you have a bicuspid aortic valve, your aortic valve has only two of these flaps instead of three.

Bicuspid aortic valve risk factors and causes

A bicuspid aortic valve is a birth defect. It's not fully clear what causes it, but some studies suggest a connective tissue disorder is partly responsible.

The two-leaflet valve starts in the early stages of a woman's pregnancy, when the heart forms.

About 2 percent of the population has bicuspid aortic valve. It's far more common in males than in females, with twice as many men having the disease.

Bicuspid aortic valve complications

In some cases, people with a bicuspid aortic valve aren't aware they have it.

In rare yet severe cases, a child born with the disease needs surgery as soon as possible.

The problem may be evident when a doctor listens to the heartbeat and hears a murmur, or an abnormal heart sound.

If the two valves don't fully close, blood may flow backward slightly, into the heart. Doctors call this aortic valve insufficiency.

The heart then works hard to get rid of that blood, which strains and weakens its left ventricle.

This extra strain will cause the left ventricle to expand over time and can lead to heart failure or an aortic aneurysm. Both of these conditions can result from stress to the heart or aorta caused by damage from a weakening of the muscles.

Weak connective tissue within the vascular system — exacerbated by age and calcification (hardening) of the arteries — can also cause aortic valve insufficiency.

For an appointment, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI.

Bicuspid Aortic Valve Symptoms and Diagnosis

Although people are born with a bicuspid aortic valve, it often goes undiagnosed until adulthood. One exception is in cases when a newborn has a pronounced valve defect and receives treatment right away.

In most cases, the valve works normally until middle age.

Bicuspid aortic valve symptoms

Symptoms of bicuspid aortic valve include:

  • A heart murmur throughout childhood. Your doctor can detect this by listening to your heart.
  • Shortness of breath when you exercise, even mildly.

Bicuspid aortic valve diagnosis

To diagnose a bicuspid aortic valve, your doctor may order the following tests:

  • Echocardiogram
  • CT scans
  • Magnetic resonance imaging (MRI)
  • Electrocardiogram
  • Angiography

For an appointment, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI.

Learn More at UPMC Health Beat

Follow the beat for a healthier life with our blog post on Heart Condition Symptoms: Now What?.

Bicuspid Aortic Valve Treatment

Most people with bicuspid aortic valves need surgery. Around 20 percent of people who have this problem will not require surgery.

Based on how complex your case, you may need valve repair or valve replacement surgery.

Make an appointment for bicuspid aortic valve treatment

For an appointment, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI.

Learn More at UPMC Health Beat

Follow the beat for a healthier life with our blog post on Aortic and Mitral Valve Disease Treatment Options.