Bicuspid aortic valve is a condition present right from the birth wherein the valve between the lower left ventricle and the aorta has only two cusps whereas a normal heart has three. Presence of cusps prevents proper flow of blood from the ventricle to the aorta because of narrowed down valves called aortic valve stenosis. The normal functioning of a valve would mean that once the blood has flown through it, it closes until the next unit of blood is ready to flow through it. But in case of a bicuspid aortic valve the cusps do not close properly thereby allowing some blood to leak back into the left ventricle. This condition is known as aortic valve regurgitation. The complications due to a bicuspid aortic valve are apparent when the affected individual is an adult or even sometimes in old age. Very few individuals show symptoms and require treatment during their childhood. An individual with BAV may show symptoms of easy fatigue, very less stamina and poor performance in cardio-intensive activities. In many cases the condition may not even show any signs or symptoms. Doctors may diagnose the condition by hearing your heart beats. If murmurs are audible, then the individual is suspected of having BAV. Thereafter an echocardiogram will prove whether the condition is truly due to BAV or not. On obtaining a positive result treatments would be required to either fix the problems. Treatments mainly include surgical methods like aortic valve replacement, balloon valvuloplasty, aortic valve repair, aortic root and ascending aorta surgery. Medication is not required for this condition and surgical treatment is opted only when progressive complications are observed.
Surgical treatment for bicuspid aortic valve is done only when progressive complications are ensued like valve stenosis, valve insufficiency, possible bacterial endocarditis or progressive aortic root dilation. Antibiotic prophylaxis is recommended only when endocarditis occurs on the bicuspid valves. Treatment will be required when the person with congenital heart disease is diagnosed with valve problems like aortic valve stenosis, enlarged aorta or aortic valve regurgitation. Thereafter, depending upon the condition of the patient the following surgical treatments may be done to improve the condition. Aortic valve replacement is the procedure wherein the damaged valve is replaced either with a valve made of human, pig or cow’s heart tissue or with a mechanical one. Sometimes even the patient’s own pulmonary valve tissue is used to replace the bicuspid aortic valve. Another treatment method is balloon valvuloplasty wherein a catheter with a balloon on its tip is inserted into an artery in the groin area. The catheter is pushed to the aortic valve and then the balloon is inflated. This opens up the valve if it got narrowed down due to aortic stenosis. Aortic root and ascending aorta surgery is done to remove the enlarged section of the aorta near the heart. After the removal a synthetic tube or graft is fixed on its place and if required the valve is also repaired.
An individual with a congenital heart disease, if experiences signs like fatigue or difficulty in cardio-oriented activities, then he/she will be recommended to consult doctor for diagnosis. Only if after diagnosis heart murmur is heard an echocardiogram will be prescribed. If after the test progressive complications are observed, only then the person will be eligible for the treatment. Generally, adults or sometimes older adults are eligible for the treatment.
Individuals with congenital heart disease other than BAV are not eligible for treatment. Also, if no symptoms are observed even if the condition is present, the person will not be eligible for treatment.
Side effects of surgical treatment with biological valve can be eventual degeneration of the valve which may again need to be replaced. Individuals with mechanical valve will be required to regularly take blood-thinning medications so that blood clots are prevented. Balloon valvuloplasty may be beneficial in children and infants but in adults, the valves may again narrow down. Also, in some people the chance of aortic regurgitation increases after the treatment.
After the surgical treatment is done, the patient will be required to follow-up appointments with the doctor or the surgeon in order to monitor changes. Some lifestyle changes must be done like quitting smoking, reduce alcohol consumption etc. Doctors recommend not to stand at one place for more than 15 minutes at a stretch, not to lift heavy weights and not to push or pull heavy objects. Regular walking must be done; smaller meals must be taken at regular intervals and if the appetite is not proper, it must be reported to your doctor.
It takes about 6 to 8 weeks to recover completely from the surgical treatment for bicuspid aortic valve.
Price of BAV treatment may range from Rs. 70,000 to Rs. 8.5 lakh.
In some surgical treatments where mechanical valves are placed, may need to be prescribed with blood thinning medication and if it is done with biological tissue replacement, that valve may need to be rep;aced again aftyer a few years.
If a person has this congenital heart disease, he/she can also consider home remedies for treating heart conditions like garlic that reduces chest pain, vitamin C which acts as antioxidant to maintain a healthy heart, broccoli, sweet potato, spinach, fresh fruits and vegetables and grape juice are all beneficial for a healthy heart. There are herbal options also available for heart diseases in the market which you can opt for. Apart from medications, regular exercise and yoga can always help in having a healthy heart.
Rs. 70,000 to Rs. 8,50,000