Where do they cut when replacing a bicuspid aortic valve?

Question

I have a bicuspid a aortic valve what changes in my life should I makei as for drinking and exercising?

Answer 1

Several: The standard surgical approach is via a mi sternotomy approach. Currently there are centers performing the surgery via a minimal thoracotomy incision as well. The latest approach is a transcatheter aortic valve replacement (tavr). Which is done withou an incision and performed though a catheter via the groin. Check with your surgeon as to which approach is best for you.

Answer 2

Many: The standard approach is a full sternotomy. There are 2 minimally invasive approaches; a mini upper sternotomy and a mini right anterior thoracotomy. If you are having an isolated aortic valve procedure, you should find a surgeon with minimally invasive experience. The transcatheter approach is only used for high risk and inoperable patients and it is contraindicated for bicuspid valves.

Answer 3

See a cardiologist: The valve is normally 3 parts, so yours with only 2 parts will "age" faster. You should have an echocardiogram perhaps annually, to follow the size of the opening. If it begins to narrow too much, surgery is indicated to replace it.

Answer 4

Serial exams: The natural history of bicuspid aortic valve is to progressively deteriorate over years and narrow (stenosis) or leak. Many need to have valve replacement in their 40s to 60s. There is no known treatment to postpone that deterioration, but you can make sure you are in the best condition possible to undergo surgery later - healthy weight, stamina from exercise, other health problems controlled.

Answer 5

Bicuspid valve: The aortic valve normally has three cusps, or leaflets. Some people are born with only two cusps of this valve, and this abnormality does increase the chance that the valve will deteriorate and require replacement. Also associated with the bicuspid aortic valve is a tendency for the first segment of the aorta to enlarge into an aneurysm. A cardiologist should monitor these conditions.

Answer 6

May worsen with age: This is a not uncommon congenital variant which is typically aysmptomatic for many years. With aging, leakage from the valve not closing properly may become a problem. Also, the valve can be a site on which infections may settle.

Answer 7

Needs to be followed: The normal aortic valve has 3 leaflets but the bicuspid valve only has 2. It is the most common valve congenital malformation. About 1-2%. The natural course is for the valve to get stiffer over time and not open wide enough. This is called stenosis. Most pts need aortic valve replacement by their 50-60's. Until that time though it should not have a significant impact. Need antibiotics for dental.

Where do they cut when replacing a bicuspid aortic valve?

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