The aortic valve separates the lower left chamber of the heart, the left ventricle and the aorta, the blood vessel that carries blood from the heart to the body. The one-way aortic valve normally has three leaflets, or cusps. Bicuspid aortic valve is a congenital condition in which there are two leaflets instead of three. Over time, a bicuspid aortic valve may fail, partially obstructing blood flow out of the heart or allowing backflow into the left ventricle. Medication, catheterization procedures and surgery remain the primary forms of treatment for a bicuspid aortic valve.
Medication
Approximately one-third of people with a bicuspid aortic valve, or BAV, develop aortic regurgitation during adulthood, reports cardiologist Gian Novaro of the Cleveland Clinic. With this condition, blood flows backward from the aorta into the heart through the malformed aortic valve. Blood volume overload causes stretching and increased muscularity of the left ventricle, also known as left ventricular hypertrophy.
Medications that dilate the blood vessels and lower blood pressure reduce backflow across a leaky bicuspid aortic valve. Types of medications used for aortic regurgitation associated with a bicuspid valve include vasodilators, calcium channel blockers and beta blockers. Although medications cannot cure aortic regurgitation or a bicuspid aortic valve, they may help slow the progression of heart complications associated with these conditions.
Balloon Aortic Vavuloplasty
Balloon aortic valvuloplasty is a heart catheterization procedure used for infants and young children with narrowing of the aortic valve opening caused by a bicuspid malformation, notes MayoClinic.com. Obstructive narrowing of the aortic valve, or aortic stenosis, significantly increases the workload on the heart and can lead to heart failure.
Balloon aortic valvuloplasty involves threading a long tube, or catheter, through an artery to the aortic valve. Inflation of a balloon at the end of the catheter stretches the valve opening to enable easier blood flow out of the heart. Among infants and children, balloon aortic valvuloplasty usually proves highly effective for relieving bicuspid valve-related aortic stenosis, reports Cincinnati Children's Heart Institute. The procedure, however, lacks long-term effectiveness when used in adults with this condition.
Aortic Valve Replacement
Patients with a bicuspid aortic valve accompanied by severe leakage or outflow obstruction may require valve replacement surgery. A mechanical valve, human donor valve or animal-derived valve may be used to replace the malfunctioning bicuspid aortic valve, explains Dr. Thoralf Sundt on the website of the Society of Thoracic Surgeons. Patients receiving a mechanical replacement valve require lifelong treatment with blood thinners, or anticoagulants, to prevent the development of blood clots.
