Bicuspid Aortic Valve

• The most common congenital heart abnormality

• Aortic valve has only two parts (cusps) instead of the normal three-cusp valve

• Can cause aortic valve regurgitation, stenosis (narrowing), or sometimes have normal function

• Often associated with abnormal dilation of aorta (big blood vessel above aortic valve)

• Need for valve replacement is common, but more often as older adult

When the heart pumps oxygen-rich blood to the body, the blood goes from the left ventricle through the aortic valve into the aorta.  The aortic valve then closes and prevents blood from going backwards into the heart.  Normally, this valve will have three separate cusps that make up the valve.  A bicuspid aortic valve has only two cusps.  Sometimes this is the result of two of the cusps being “fused”, or not separated from each other.  Sometimes there are only two actual cusps.  Regardless, this abnormality can sometimes lead to the valve not opening fully and causing aortic stenosis, which is narrowing of the valve with obstruction of blood flow out of the heart.  Bicuspid valves will also often have regurgitation of blood back into the heart.  The heart and body can tolerate mild to moderate aortic stenosis and/or regurgitation well.  If the stenosis or regurgitation is severe, however, the heart and body have difficulty adapting to this problem and intervention of some type is necessary.  Interventions range from procedures that can be performed in the catheterization lab to open heart surgical procedures.