Bicuspid Aortic Valve Treatment & Management
- Author: Edward J Bayne, MD; Chief Editor: Steven R Neish, MD, SM more...
No specific medical care is required for individuals with bicuspid aortic valve unless they have progressive deterioration or infection. Serial follow-up evaluations are important for early recognition of potential complications (valve insufficiency, valve stenosis, progressive aortic root dilation) and the prevention of possible bacterial endocarditis.
Surgery specifically for bicuspid aortic valve is not necessary unless progressive complications ensue (valve insufficiency, valve stenosis, progressive aortic root dilatation, possible bacterial endocarditis).
The patient with known bicuspid aortic valve no longer requires antibiotic prophylaxis for invasive dental or noncardiac surgical procedures. If endocarditis has occurred on a bicuspid aortic valve, antibiotic prophylaxis is recommended.
For noncardiac procedures, preoperative cardiac evaluation may be appropriate, particularly for patients with aortic stenosis or insufficiency. The patient with simple, uncomplicated bicuspid aortic valve should not require special anesthetic precautions, other than bacterial endocarditis prophylaxis, when appropriate.
Because hypercholesterolemia and other coronary artery disease risk factors may accelerate the sclerosis and deterioration of a congenitally bicuspid aortic valve, a heart-healthy diet is recommended for all patients, not only those with recognized risk factors. This diet should limit fat calories to no more than 30% of total calories. Calories from saturated fats should be limited to no more than 10% of total.
Patients with normally functioning bicuspid aortic valves (ie, no stenosis or insufficiency) do not require activity restrictions. They may participate in organized competitive sports activities after echocardiography or MRI to assess for dilated aorta.
Patients who develop valve insufficiency or stenosis from a congenitally bicuspid aortic valve may require restrictions from strenuous competitive sports.
Patients with aortic valve insufficiency should avoid strenuous isometric activity, such as weight lifting, rope climbing, and pull-ups.
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