Bicuspid Aortic Valve: Long-Term Monitoring
The most common congenital heart defect requires careful lifelong surveillance.
What Is a Bicuspid Aortic Valve?
A bicuspid aortic valve (BAV) is the most common congenital heart defect, affecting 1–2% of the population. Instead of the normal three leaflets, the aortic valve has only two. Many people with BAV are asymptomatic for decades, but the valve is prone to earlier degeneration, stenosis, or regurgitation compared to a normal tricuspid valve. BAV is also associated with aortic dilation (aortopathy), which requires separate monitoring.
When Is Intervention Needed?
Intervention — either surgical valve replacement or, in select cases, valve repair — is typically recommended when severe stenosis or regurgitation develops, when the aorta dilates beyond safe thresholds, or when symptoms such as shortness of breath, chest pain, or syncope appear. Regular echocardiographic surveillance and, when indicated, CT or MRI imaging of the aorta allow your ACHD cardiologist to time intervention optimally.