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Bi-cuspid aortic valve
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Bi-cuspid aortic valve

I'm a 43 year old male and have know of my valve for only 9 years. I have had echo's done 9 years ago and was fine at that time. My second one was March of 97 and I had some leakage. Nov. of 98 I had more as and my left ventricle was dialated. My doctor said I had a severe leakage, but it wasn't a emergency. I had my third echo in June 99 and he said there was a slight change and he would see me in Dec. of 99 for another echo. I have had a few times when I first do some lifting or climbing movements that I have a slight shortness of breath. I should also tell you I am a full time firefighter and am thinking that this may not be the best place to be right now and feel I should think of having the valve replaced and heal up and get back to work. I am working my full work at this time. Do you have any thoughts on my condition and my age etc.? Thanks for you time and response.
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Dear Noel,

The aortic valve is the valve that separates the left ventricle from the aorta.  It is made of 3 leaflets or flaps that look like an peace symbol when the valve is closed.  A bicuspid aortic valve means that there are 2 leaflets instead of the usual 3.  A unicuspid valve means there is only one leaflet.   Bicuspid aortic valve is the most common congenital anomaly of the heart.  These valves are functional at birth and remain so throughout a normal life span.  There is a increased predisposition to progress to stenosis (narrowing) as an older adult (60-70's) and surgical repair may be required at that time.  Replacement is not generally required until the valve has an area of less than 1 cm2.  There is also some increase in the incidence of infective endocarditis (infection of the valve).  There is also a risk of regurgitation occuring that may require valve replacement.  The timing of valve replacement is more of an art than a science and your doctor is right to follow you closely.  You are probably getting close to the time and you should discuss timing with your doctor at your next visit.
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