Harvard Heart Letter

What is a bicuspid aortic valve?

Ask the Doctor

Q. My primary care doctor referred me to a cardiologist, and I just found out that I have a bicuspid aortic valve. What does that mean for me?

A. The aortic valve sits between the heart and the aorta, the main artery from the heart that distributes oxygen-rich blood throughout the body. A normal aortic valve has three leaflets, or flaps, that open and close tightly to regulate the flow of blood. But between 1% and 2% of people are born with an aortic valve that has only two flaps, known as a bicuspid valve. This defect is twice as common in males as in females and often runs in families.

People with a bicuspid aortic valve have a higher-than-average risk of developing a condition called aortic stenosis—in which the valve becomes stiff and narrowed—that usually produces a heart murmur. A more serious problem that can occur is a bulge or swelling in the wall of the aorta, called an aortic aneurysm. It usually happens in the thoracic aorta, the part of the aorta that passes through the upper chest. Very rarely, the aorta can tear or burst, which is often fatal. However, surgery to replace the valve (and sometimes part of the aorta) can prevent these problems.

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