The clinical importance of the bicuspid aortic valve, which was first described by Leonardo da Vinci in history, was defined in the late 1800s. In this regard, it would be useful to first discuss the structure and functions of the bicuspid aortic valve.
There are 4 chambers in the heart that contain blood. Two of these chambers are located in the right and the other two are in the other left half of the heart. The first blood coming to the heart passes from the right chambers through the valves and passes to the lungs to ensure oxygenation. Blood, enriched in oxygen, passes through the valves in the left chambers of the heart and is sent to our body through the aortic valve through the contraction of the heart.
Valves located within the heart chambers are structures that prevent blood from being sent forward and escaping back. However, if there are problems in the blood moving forward or if the blood leaks back, the load on the heart increases. In this case, some problems may occur not only in the heart but also in the organs that need blood.
Bicuspid aortic valve,Instead of the valve in the aortic artery coming out of the heart, that is, the left ventricle, having 3 parts (leaflets). It is the case of having 2 leaflets. As stated above, this situation may cause problems in the correct flow of blood, as well as the problem of blood backflow. As a result, problems are observed in the heart and other organs along with the bicuspid aorta. If the bicuspid aortic valve is functionally normal, it can continue throughout life without any problems and no intervention is required.
Bicuspid Aortic Valve Disease
Bicuspid aortic valve is a condition that occurs in approximately 0.5-2% of the adult population. Bicuspid aortic valve is a congenital heart disease. Although this disease has a genetic factor, it is frequently seen in first-degree family members. Shape differences in bicuspid aorta cause problems such as calcification, deterioration or stenosis in the valve structure over time. In addition, valve insufficiency problems are also added to this table. Therefore, some patients may require surgical treatment and valve replacement. This surgical operation Although it is vital that the procedure is performed appropriately and at the right time, it is a critical point not to be late.
Although the disease is congenital, it can hide itself silently for many years. Bicuspid aortic valve disease can develop without showing symptoms, or it can present itself with isolated aortic valve regurgitation, isolated aortic stenosis, aortic dilatation, or a combination of these conditions. Usually, this condition is diagnosed by chance at later ages. Apart from the complaints mentioned above, this disease can be easily diagnosed by a heart murmur heard during an examination. The diagnosis is confirmed with echocardiography by a cardiologist who is an expert in his field.
Bicuspid Aorta Symptoms
Bicuspid aortic valve usually does not cause significant complaints until the ages of 30 to 40. . In cases where it does not cause any symptoms before this age, it is usually diagnosed incidentally. Symptoms and patient complaints generally manifest themselves starting from the age of 40.
There are two particularly noteworthy bicuspid aorta; The main symptoms are shortness of breath and fatigue. In addition, complaints of palpitations, fainting, fainting, fatigue and weakness can be added to this table. In addition to all these, some patients may also complain of chest pain. In the later stages of the disease, if the heart enlarges and causes heart failure, it can cause paralysis and sudden death.
Some problems arise as a result of bicuspid aorta. Heart failure may occur especially due to oart valve stenosis or insufficiency. As a result of such situations; Risks of shortness of breath, chest pain, fatigue, arrhythmia (heart rhythm problems), palpitations during exertion, valve infection (endocarditis) and, in advanced cases, sudden death may occur.
Bicuspid Aortic Valve Treatment
Bicuspid aortic valves are structurally problematic valves and cannot be treated with medication. For this reason, only surgical treatment of this disease, that is, structural disorder, is possible. Two different techniques are used in these treatment methods. . The first technique is aortic valve repair, and the second technique is aortic valve replacement.
Valve repair is generally performed in surgical operations. During the repair process, the leaflets are reshaped to open and close better. This procedure is performed for valves with aortic insufficiency. However, in patients where valve repair is not possible, the valve is usually removed and replaced with an artificial valve. In artificial valve operations, depending on the characteristics of the person, completely metallic valves or bioprosthetic valves containing partially organic material can be preferred.
The timing of intervention in aortic valve operations is a very important criterion. As a result of not choosing this timing correctly, the risks posed by prosthetic valves may increase and longer-term risks may occur. Therefore, in order to minimize the risks, the timing of the intervention must be carefully determined by the specialist physician. In addition, failure to treat bicuspid valve when necessary may lead to irreversible changes and damage in the heart and other organs.
In order to monitor the damage and changes in the heart tissue, an examination accompanied by echocardiography should be performed at least once a year. If the disease progresses, regular follow-up and control is required. After regular follow-up, when complaints begin, the treatment process is started according to the table. In this regard, we can say that regular follow-up and check-ups of bicuspid aorta patients are of great importance for the treatment process.
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