Question:
My 11-year-old son was recently diagnosed with a bicuspid aortic valve. What is this? Can he participate in competitive sports? Will he ever need surgery or medical treatment for this?

Answer:
The term bicuspid aortic valve refers to the leaflets of the aortic valve. This is the valve that leads out of the heart to the aorta, the big blood vessel that delivers oxygen-rich blood to the body. Normally, the aortic valve has three leaflets. A bicuspid valve has only two leaflets.

Because of this, patients with a bicuspid valve may develop a narrowing or leakage of the aortic valve. Narrowing or leakage of aortic valves do not necessarily develop in childhood, but may occur in adulthood. On rare occasions these problems require repair, either with a balloon (cardiac catheterization) or surgery. To determine whether narrowing or leakage is present and related to the bicuspid aortic valve, the cardiologist follows the patient with non-invasive tests that may include: electrocardiograms, echocardiograms and stress tests. If narrowing or leakage of the valve becomes severe enough to require intervention, your doctor will explain this to you in more detail. In many cases, bicuspid aortic valves do not require any intervention in childhood and children with them may not need activity restriction. A pediatric cardiologist will make specific recommendations for activity restrictions for each patient based on the severity of the valve narrowing or leakage. Restrictions may be put in place to assure that a normal amount of oxygen gets to the patient's heart muscle at all times.