Bicuspid aortic valve is one of the most common congenital cardiac anomalies. Normally, the aortic valve consists of three leaflets. A bicuspid valve has two leaflets. The vast majority of people with bicuspid valves have normally functioning valves in childhood and early and mid adulthood. The valve may remain functionally normal throughout life or it may undergo progressive calcification and thickening resulting in progressive narrowing which limits the hearts ability to pump blood (aortic stenosis) or the valve may become incompetent and "leak " ( aortic regurgitation). Aortic stenosis secondary to bicuspid aortic valve accounts for approximately fifty percent of all surgical cases of aortic stenosis in the United States. In addition, there is evidence to suggest that some people with bicuspid valves have structurally abnormal aortas and are prone to dissection. This is a relatively rare complication. Furthermore, since the valve is structurally abnormal, it is prone to becoming infected (endocarditis).
It is recommended that people with bicuspid aortic valves be followed by a physician. Antibiotic prophylaxis is also suggested prior to certain procedures. ( dental work, certain gastrointestinal and urologic procedures and certain surgeries). Echocardiograms to assess the structure and functional status of the valve on an annual basis. Certainly, if the patient experiences any symptoms suggestive of valvular stenosis, incompetence or infection ( shortness of breath, fatigue, leg swelling, fever, etc