What is the treatment for a bicuspid aortic valve?

What is the treatment for a bicuspid aortic valve?

About 4 out of 5 people with bicuspid aortic valve disease need aortic valve surgery. New technology continues to improve outcomes and reduce complications. Many people can have minimally invasive techniques instead of traditional open heart surgery. Your surgeon will either repair or replace your aortic valve. Your surgeon may also fix other issues (like an aneurysm) at the same time.

Your provider will evaluate your situation, run some tests and talk with you about your treatment options. Your treatment will depend on the condition of your aortic valve and aorta. But your provider will also consider your overall heart health, age and other medical conditions.

It’s important to have surgery early enough to prevent permanent damage to your heart. Even if you don’t have symptoms, your provider may want to fix the problem now to avoid complications down the road. The best timing is different for everyone. Your medical care team will discuss your options with you.

Traditional aortic valve surgery vs. minimally invasive aortic valve surgery

Traditional (open heart) aortic valve surgery involves a 6- to 8-inch incision down the middle of your sternum (breastbone). Your sternum is divided so your surgeon can directly access your heart.

Minimally invasive aortic valve surgery involves a smaller “J” incision (2 to 4 inches). The incision will be at the top of your sternum or between your ribs. Your surgeon doesn’t need to open your whole chest. This procedure reduces blood loss and allows you to leave the hospital sooner. You may also recover more quickly.

Aortic valve repair vs. aortic valve replacement

Aortic valve repair fixes your valve without replacing it. It can be a good option for aortic regurgitation (leaky valve). But it can’t be used to treat aortic stenosis (narrowing). Aortic valve repair can often be done through a minimally invasive surgery with the “J” incision. Your surgeon will reshape your aortic valve cusps to help them open and close more completely.

Aortic valve replacement is used when a repair isn’t possible. It involves removing your valve and giving you a new one. This procedure can be done through traditional open surgery. Or, it can use the minimally invasive transcatheter aortic valve replacement (TAVR) method.

There are two main options for your new valve: biological or mechanical.

• Biological valve. This type of valve is used 80% of the time. It’s made from pig or cow tissue. This valve is safe and durable. But after ten years, you may need another replacement surgery.
• Mechanical valve. This type of valve is very durable and can last the rest of your life. But you need to take blood thinners for your whole life to keep it working safely.

Many people prefer a biological valve so they don’t have to take blood thinners. But it depends on your age, other medical conditions and personal preferences. Your provider will discuss your options and help you decide what’s best for you.

Another option for valve replacement is the Ross procedure (also called the switch procedure). It involves using your pulmonary valve to replace your aortic valve. This procedure can be a good option for people under age 50 who want to avoid long-term use of blood thinners.

Risks of surgery

Generally, valve surgeries have a low risk of complications. But possible risks include:

• Infection.
• Blood clots.
• Stroke.
• Arrhythmia (temporary).
• Reduced kidney function (temporary).

About 98% of people who have valve surgery survive and have a normal life expectancy.