Bicuspid aortic valve is a type of congenital heart valve disease seen in the aortic valve located in the heart. In individuals with bicuspid valve disease, the heart may have difficulty pumping the blood needed for the body. Bicuspid aortic valve disease, which presents with various symptoms, may pave the way for more serious heart diseases if left untreated. This condition that develops in the aortic valve can occur for various reasons and can be controlled with early diagnosis and treatment.
What is a Bicuspid Aortic Valve (BAC)?
The aortic valve is one of the four valves in the heart. and helps blood move from the left ventricle to the aorta, the artery that delivers blood to most of the body. Generally, the aortic valve has three leaflets or flaps that open and close with the heartbeat, allowing blood flow from the heart to the aorta. Each time the heart contracts, these valves in the aorta open and close. Bicuspid disease occurs with congenital aortic heart valve with two leaves. This leads to cardiac complications and causes the heart to not work efficiently. The tricuspid aortic valve, which is a 3-leaf valve, generally opens and closes easily and safely. However, the aortic valve leaves that are abnormally congenital bicuspid may be thicker than normal, making it difficult for the leaves to open and close properly. causes overwork. Sometimes, in the early stages of bicuspid aortic disease, the heart may work normally. However, the valves can thicken over time due to uneven blood flow throughout the valve. This is bicuspid aortic disease. The heart function, which may be normal at first, may lead to deterioration of the heart function in the future. In some patients with bicuspid aorta, the valve does not close tightly and blood may leak. When the blood that needs to be pumped to the body flows back to the heart, this can lead to aortic valve insufficiency disease, which causes the heart to work harder.
Bicuspid Aortic Symptoms
In the initial period of bicuspid aortic valve disease, the heart valve Since the disease can work properly, the disease may not show any symptoms for a long time. In some cases, symptoms may not manifest until adulthood. However, if a newborn baby has a very narrow aortic valve or has serious problems with the valve, symptoms may appear soon after birth. Symptoms associated with bicuspid aortic disease can be listed as follows:
- Pain and discomfort in the chest
- Dizziness
- Inability to exercise due to exhaustion
- Severe shortness of breath
- Burnout
- Fainting
- Heart palpitations
- Pale skin
- Having difficulty breathing
- Problems with nutrition or weight gain
- Aortic valve insufficiency
- Aortic Valve stenosis
- Heart failure
- Aortic aneurysm
- Endocarditis: Inflammation of the heart inner layer and heart valves.
- Arrhythmias
How to Diagnose Bicuspid Aorta?
Because the symptoms of bicuspid aortic valve syndrome are similar to the symptoms of many diseases, doctors may have difficulty in diagnosing the disease. Therefore, the patient Special tests may be required to diagnose the disease. The doctor primarily examines the patient in a general way and reviews the patient's medical history. He then listens carefully to the patient's heart with the help of a stethoscope. If he detects any heart murmur (a different additional sound) while listening, he will order more detailed tests to understand the situation more clearly. The methods used to diagnose bicuspid aortic disease can be listed as follows:
- Echocardiography (ECO): Echocardiography device; It reflects the movements, internal structure and function of the heart to the computer screen using sound waves. Thanks to this test, the flow of blood in the heart can be examined and problems in the heart vessels and heart valves can be detected.
- Electrocardiography (ECG): Electrocardiography, which provides a detailed examination of the electrical energy generated by the heart; Thanks to the electrodes placed on the chest area, wrists and ankles, it reflects this energy on the computer screen. The computer turns this electrical energy into a graphic that the doctor can read.
- Chest X-ray: This X-ray, which enables the examination of the heart and blood vessels in the heart, provides an image using X-rays.
- Cardiac Computerized Tomography (CT): Computed tomography provides a detailed examination of the heart and vessels using X-rays. It pulls the chest area from different angles and combines them to obtain a three-dimensional image.
- Magnetic Resonance Imaging (MRI): Magnetic resonance imaging device, which contains large magnets, creates a large magnetic field with the help of these magnets. Thanks to this magnetic field, it allows the heart and heart vessels to be examined in detail.
Bicuspid Aortic Treatment
In order to perform the bicuspid aorta treatment, the severity of the condition and the appropriate treatment should be determined first. 2-leaf aortic valve treatment can be provided with more than one method. When there are no symptoms, doctors call the patient at regular intervals to evaluate the heart. Thus, in a potentially risky situation, the situation can be brought under control with early intervention. When symptoms occur, it may be necessary to replace or repair the heart valves. Bicuspid aortic valve surgery may be required for this procedure. This surgery can be performed in the form of open heart surgery. In some cases, the angiography method can also be used. In general, 2-leaf aortic valve surgery can be performed in the following ways:
- Aortic valve surgery: In this procedure, the rib cage is cut vertically in half and the heart is exposed. In this way, operation can be performed on the heart.
- Minimally invasive aortic valve surgery: In this procedure, which is performed with a smaller incision, the incision is made over the chest and ribs. Minimally performed bicuspid valve surgery can allow operation on the heart without opening the entire chest. In addition, it is possible to change the aortic valve through a catheter, which is another minimally invasive method in suitable patients. In this way, blood loss is less and a faster healing process can occur.
- Aortic valve repair: In this procedure, the valve is , can be repaired without replacement. This method, which is especially used to treat aortic regurgitation, is usually performed with a minimally invasive procedure. The surgeon reshapes the aortic valves to make them tighter.
- Ao rt cover replacement: When it is not possible to repair the covers, the covers may need to be changed completely. This procedure can be performed with open heart surgery or the TAVI method, which is a minimally invasive surgical procedure. There are two options for new covers to be fitted.
- Biological cover: These covers made of pig or cow tissue can be used for many years; however, it has a shorter lifespan than mechanical valves.
- Mechanical valve: People who use these valves regularly use blood thinners in order for the blood to spread throughout the body regularly. In this way, blood clot formation is prevented.
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