Anomalies of the LVOT: Bicuspid Aortic Valve

Question 1

A bicuspid Aortic valve is sometimes missed if it is not ____.

Answer 1

stenotic

Question 2

A bicuspid aortic valve is more ____ than stenotic.

Answer 2

insufficient

Question 3

Name common effects on a heart with a bicuspid aortic valve.

Answer 3

1. dilated LV / decreased function
2. AI
3. Dilated AO root
4. Shortened coronaries
5. Coarction of descending AO

Question 4

A bicuspid aortic valve means that there are only 2 cusps. The ____ cusp is normally the larger one.

Answer 4

anterior

Question 5

What is a Rafeigh?

Answer 5

A ridge of tissue where a valve should have separated. It can appear to be valve separation in Echo.

Question 6

Physical signs and symptoms of patients with a bicuspid Aortic Valve:

Answer 6

1. LV dilation
2. LV Hypertrophy
3. Murmur sounds like AS or AI
4. evidence of CHF
5. systemic HTN
6. PHTN
7. PVCs, VFIB, VTACH
8. SOB
9. Fatigue
10. Poor exercise tolerance
11. Kidney failure (responding to low blood pressure)
12. Decreased BP in extremities

Question 7

Surgical Repair for a stenotic bicuspid aortic valve?

Answer 7

1.Balloon Valvuloplasty
(attempt to open up the valve with a balloon)
2. Ao valve replacement
(tissue valve only, in the patient’s early 20’s)
3. Repair descending AO coarct