Bicuspid aortic valve

The bicuspid aortic valve is a heart condition present from birth. That means that it is a congenital defect of the heart.

The aortic valve lies between the left lower chamber of the heart and the body's main artery, called the aorta. Flaps of tissue in the valve open and close with each heartbeat. The flaps are called edges. They make sure that the blood flows in the correct direction.

Normally, the aortic valve has three cusps. A valve bicuspid has only two cusps. On rare occasions, some people are born with an aortic valve that has a cusp or four cusps. A valve with a cusp is called unicuspid. A valve with four cusps is called quadricuspid.

The changes of the aortic valve can cause health problems, including:

  • Narrowing of the aortic valve, called aortic valve stenosis. The valve may not open fully. The flow of blood from the heart to the rest of the body is reduced or blocked.
  • Retrograde flow of blood, called aortic valve regurgitation. Sometimes, the bicuspid aortic valve does not close tightly. This causes the blood to flow backwards.
  • Enlargement of the aorta, called aortopathy. An enlargement of the aorta increases the risk of a tear in the lining of the aorta. This wear is called an aortic dissection.

Symptoms

If the valve bicuspid causes of severe aortic stenosis or severe aortic regurgitation, symptoms may include:

  • Pain in the chest.
  • Shortness of breath.
  • Difficulty exercising.
  • Fainting or near fainting.

The majority of people with bicuspid aortic valve does not have symptoms of heart valve disease until they are adults. But some babies can have severe symptoms.

When to see a doctor

If you think that you or your baby has symptoms of a heart disease, make an appointment for a health checkup right away.

Causes

Bicuspid aortic valve occurs while the baby is still not born, also called a fetus, is growing during pregnancy. Health care professionals are not sure what the cause of the majority of congenital heart defects, such as bicuspid aortic valve. But genetics may play a role in the cause of bicuspid aortic valve.

Risk factors

A family history of early heart disease may increase the risk of developing heart valve disease, such as bicuspid aortic valve. Sometimes, the bicuspid aortic valve is run in families, meaning that it is inherited.

Diagnosis

A bicuspid aortic valve can be found when tests are done for another health problem. The health care provider may hear a heart murmur when listening to the heart.

An echocardiogram can confirm a diagnosis of bicuspid aortic valve. This test uses sound waves to create videos of the beating of the heart. It is shown how the blood moves through the heart chambers, heart valves and the aorta.

If you have a bicuspid aortic valve, usually have a ct scan to detect changes in the size of the aorta.

Treatment

If you have a bicuspid aortic valve, which are usually sent to a doctor trained in congenital heart disease. This type of doctor is called a congenital cardiologist.

Any person with a bicuspid aortic valve needs regular health check-ups and tests of image. Echocardiograms can be checked by a narrowing or leaking of the aortic valve. The test also looks for changes in the size of the aorta.

The treatment for a bicuspid aortic valve depends on the severity of the disease of the heart valve is. You can include medications or a procedure or a surgery to repair or replace the valve.

Drugs

There are No drugs for the repair of a bicuspid aortic valve. But medicines can be used to treat the symptoms caused by heart valve disease. For example, your health care professional may recommend a blood pressure medication.

Surgeries or other procedures

Surgery may be needed if a bicuspid aortic valve is the cause:

  • Stenosis of the aortic valve.
  • Aortic valve regurgitation.
  • An enlargement of the aorta.

A surgery is performed to repair or replace the aortic valve. The type of surgery depends on the heart valve of the condition and its symptoms.

  • Replacement of the aortic valve.The surgeon removes the damaged valve. It is replaced by a mechanical valve or a valve from a cow, pig or human heart tissue. The tissue valve that is called a biological tissue valve. Sometimes, the aortic valve is replaced with the person's own pulmonary valve. The lung of the valve is replaced with a lung tissue valve from a deceased donor. This more complicated the surgery is called the Ross procedure. Biological tissue valves will break down over time. They may eventually need to be replaced. If you have a mechanical valve, you need to take blood thinners for life, to prevent the formation of blood clots. Together, you and your health care team can talk to you about the benefits and risks of each type of valve.
  • Of the aortic root and ascending aorta surgery. Surgeons remove the enlarged section of the aorta that lies close to the heart. Is replaced with a synthetic tube, called a graft, which is sewn into place. Sometimes, only the extended part of the aorta is removed. The aortic valve is maintained. The aortic valve can also be replaced or repaired during the surgery.
  • The balloon valvuloplasty.This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So that's usually only done if you are too sick for surgery, or you're waiting for a replacement of the valve. The heart valve treatment uses a thin, flexible tube called a catheter. The catheter has a balloon on the tip. The surgeon inserts the catheter into an artery in the arm or in the groin. Then, the catheter is guided to the aortic valve. Once in place, the balloon is inflated, causing the opening of the valve is larger. The balloon is deflated. The catheter and balloon are removed.

Replacement of the aortic valve. The surgeon removes the damaged valve. It is replaced by a mechanical valve or a valve from a cow, pig or human heart tissue. The tissue valve that is called a biological tissue valve. Sometimes, the aortic valve is replaced with the person's own pulmonary valve. The lung of the valve is replaced with a lung tissue valve from a deceased donor. This more complicated the surgery is called the Ross procedure.

Biological tissue valves will break down over time. They may eventually need to be replaced. If you have a mechanical valve, you need to take blood thinners for life, to prevent the formation of blood clots. Together, you and your health care team can talk to you about the benefits and risks of each type of valve.

The balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants and children. In adults, the aortic valve tends to narrow again after the procedure. So that's usually only done if you are too sick for surgery, or you're waiting for a replacement of the valve.

The heart valve treatment uses a thin, flexible tube called a catheter. The catheter has a balloon on the tip. The surgeon inserts the catheter into an artery in the arm or in the groin. Then, the catheter is guided to the aortic valve. Once in place, the balloon is inflated, causing the opening of the valve is larger. The balloon is deflated. The catheter and balloon are removed.

Lifestyle and home remedies

Anyone who was born with a bicuspid aortic valve needs of the health examinations for life. A medical doctor trained in diseases of the heart, called a cardiologist, you should examine whether there are changes in your condition.

People with a bicuspid aortic valve are more likely to get an infection of the inner lining of the heart chambers and valves. This infection is called infective endocarditis. Proper dental care can help reduce your risk.

A bicuspid aortic valve may be hereditary, meaning that it is inherited. Parents, children and siblings of someone with a bicuspid aortic valve should have an echocardiogram to check for the condition.

Diagnosis

A congenital heart defect may be diagnosed during pregnancy or after birth. The signs of certain congenital heart defects can be seen in a routine pregnancy test, ultrasound (fetal ultrasound).

After the baby is born, a health professional might think that there is a congenital defect of the heart if the baby has:

  • The growth of the delays.
  • The changes of Color on the lips, tongue, or nails.

The health care provider may hear a sound called a murmur, while listening to the child's heart with a stethoscope. Most heart murmurs are innocent, which means that there is no defect in the heart and the whisper is not dangerous to the health of your child. However, some of murmurs may be caused by changes in blood flow to and from the heart.

Tests

Tests for the diagnosis of a congenital defect of the heart include:

  • Pulse oximetry. A sensor that is placed at the tip of the fingers of the records of the amount of oxygen in the blood. Very little oxygen can be a sign of a heart or lung problem.
  • Electrocardiogram (ECG or EKG). This quick test records the electrical activity of the heart. It is shown how the heart is beating. Adhesive patches with sensors, called electrodes, to attach in the chest and sometimes the arms or legs. The cables connect the patches to a computer, that prints or displays the results.
  • The echocardiogram. Use sound waves to create images of the heart in motion. An echocardiogram shows how blood moves through the heart and the heart valves. If the test is performed at a baby before birth, it is called a fetal echocardiogram.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. It can show whether the heart is enlarged, or if the lungs contain blood or other liquid. These could be signs of heart failure.
  • The cardiac catheterization. In this test, the doctor inserts a thin, flexible tube called a catheter into a blood vessel, usually in the groin area, and the guide for the heart. This test can provide detailed information on the flow of the blood and how the heart works. Some heart treatments can be done during cardiac catheterization.
  • Magnetic resonance imaging of the heart. It is also called a cardiac mri, this test uses magnetic fields and radio waves to create detailed pictures of the heart. A cardiac mri may be done to diagnose and evaluate congenital heart defects in adolescents and adults. A heart mri creates 3D images of the heart, which allows accurate measurement of the heart chambers.

Treatment

The treatment of congenital heart defects in children depends on the heart problem and how severe it is.

Some congenital heart defects do not have a long-term effect on the health of a child. You can go untreated.

Other congenital heart defects, as a small hole in the heart, it can close like a child ages.

Serious congenital heart defects need to be treated soon after it was found. Treatment may include:

  • Drugs.
  • Cardiac procedures.
  • Heart surgery.
  • Heart transplant.

Drugs

Medications can be used to treat the symptoms or complications of a congenital heart defect. Can be used alone or with other treatments. Drugs for congenital heart defects are:

  • Blood pressure drugs. Examples include the angiotensin-converting enzyme (ace) inhibitors, angiotensin 2 receptor blockers (Arbs), and beta-blockers.
  • Water pills, also called diuretics. This type of medicine helps to remove fluid from the body. They help to lower the strain on the heart.
  • The heart rhythm drugs, called anti-arrhythmics. These medicines help control irregular heartbeats.

Surgery or other procedures

If your child has a serious congenital heart defect, a heart procedure or surgery may be recommended.

Heart procedures and surgeries for the treatment of congenital heart defects are:

  • The cardiac catheterization. Some types of congenital heart defects in children can be repaired using a thin, flexible tubes called catheters. These treatments allow doctors to fix the heart without open heart surgery. The doctor inserts a catheter through a blood vessel, usually in the groin, and the guide for the heart. Sometimes more of a catheter. Once in place, the doctor threads of small tools through the catheter to correct the condition of the heart. For example, the surgeon can fix the holes in the heart or in areas of narrowing. Some catheter treatments that have been carried out in steps over a period of years.
  • Heart surgery. A child may need open-heart surgery or minimally invasive heart surgery to repair a congenital heart defect. The type of heart surgery depends on the change in the heart.
  • Heart transplant. If a severe congenital heart defect can't be fixed, a heart transplant may be necessary.
  • Fetal cardiac intervention. This is a type of treatment for a baby with a heart problem, which is carried out before the birth. Can be done to fix a congenital defect of the heart or prevent complications as the baby grows during pregnancy. Fetal cardiac intervention is rarely done and is possible only in very specific situations.

Some children are born with a congenital defect of the heart in need of many procedures and surgeries over the life. Lifelong follow-up care is important. The child is in need of regular health checkups by a physician skilled in diseases of the heart, called a cardiologist. The follow-up care may include blood tests and imaging tests to check for complications.

Lifestyle and home remedies

If your child has a congenital heart defect, lifestyle changes may be recommended to keep the heart healthy and prevent complications.

  • Sports and activity restrictions. Some children with a congenital heart defect may need to reduce the exercise and sports activities. However, many others with a congenital heart defect may participate in such activities. Your child's care professional can say that the sports and types of exercise are safe for your child.
  • The use of preventive antibiotics. Some congenital heart defects may increase the risk of infection of the heart lining or valves of the heart, called infective endocarditis. Antibiotics may be recommended before dental procedures to prevent infection, especially for people who have a mechanical heart valve. Ask your child's heart doctor if your child needs to take preventive antibiotics.

Coping and support

You may find that talking with other people who have gone through the same situation brings comfort and encouragement. Ask your health care team if there are any support groups in your area.

Living with a congenital heart defect, you can make some children feel stressed or anxious. Talking with a counselor can help you and your child to learn new ways to manage stress and anxiety. Ask a health care professional for information on counselors in your area.

Preparing for your appointment

A life-threatening congenital heart defect is usually diagnosed shortly after birth. Some may be discovered before birth during an ultrasound of the pregnancy.

If you think your child has symptoms of heart disease, talk to your health professional. Be prepared to describe the symptoms of your child and provide a medical history of the family. Some birth defects of the heart you tend to be passed down through the families. That means that you inherit.

What you can do

When you make the appointment, ask if there is something that your child needs to do in advance, such as avoiding food or drink for a short period of time.

Make a list of:

  • Your child's symptoms, if any. Include those that may seem unrelated to congenital heart defects. Also note when they started.
  • Important personal information, including a family history of congenital heart defects.
  • Any infection or health conditions of the child's birth mother has or has had, and if alcohol was used during pregnancy.
  • All medications, vitamins or other supplements taken during pregnancy. Also include a list of medications that your child takes. Including those bought without a prescription. Also include the dose.
  • Questions to ask your health care team.

Prepare a list of questions can help you and your health care team to make the most of your time together. If your child is diagnosed with a congenital defect of the heart, ask the specific name of the condition.

Questions for the professional of the health can include:

  • What evidence does my child need? Do these tests have any kind of special preparation?
  • Does my child need treatment? If so, when?
  • What is the best treatment?
  • Is my child at risk of long-term complications?
  • How can we see about the possible complications?
  • If I have more children, what are the chances that you will have a congenital heart defect?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

What to expect from your doctor

Your child's health care team may ask you many questions. Be prepared to answer them you can save your time to go through all the information that you want to spend more time. The health care team may ask:

  • When did you first notice the symptoms of your child?
  • How would you describe your child's symptoms?
  • When do these symptoms occur?
  • The symptoms come and go, or does your child always have?
  • The symptoms seem to get worse?
  • Is there something that your child's symptoms better?
  • Do you have a family history of congenital defects of the heart or congenital heart disease?
  • Your child has been growing and the developmental milestones as expected? (Ask your child's pediatrician if you are not sure.)
The symptoms and treatment of Congenital heart defects in children