Bicuspid Valve and Aortic Root replacement

[Red_Baron]

Hi, I’m new to the forum today and would be grateful for any thoughts/help/feedback. About 2 years ago I was diagnosed with a bicuspid aortic valve with associated dilation of the aortic root. Despite taking Candesartan, the root dilation has continued and today I was informed of the intention to intervene (operate) - probably within the next 3-6 months.

My mind is full of questions (and anxiety) right now so any thoughts and advice would be gratefully received.

[Fortepiano]

It's worth asking your questions rather than going round and round in your mind with them - that just fuels your anxiety.

I think the important thing is to be happy with your choice of hospital and surgeon ( you should be in a specialist centre ) and then trust them.

The big question with AVR is of course choosing either a tissue or mechanical prosthetic valve, and nobody can make that choice for you. Both are possible with an aortic graft. If your bicuspid valve functions well, then it is possible to have a valve-sparing root replacement, though I'm not sure whether this is available outside the Royal Brompton. Both valve-sparing and tissue mean another operation is likely to be necessary in the future, but avoid the risks of warfarin. It's a very personal decision.

If you choose tissue the new Resilia valve is likely to be more long-lasting,, and can be used with an aortic graft; if you choose mechanical weekly self- testing helps reduce the risks of warfarin.

I had AVR with an aortoplasty ( no graft, as my aorta was only dilated). I did feel absolutely shattered, but almost immediately you are on the upward recovery curve in small steps, and surprisingly soon the whole thing is behind you and normal life goes on.

[Red_Baron in reply to Fortepiano]

Many thanks for this. The cardiologist has already made a recommendation regarding the surgeon and the operation will take place at the Harefield Hospital (which I believe is in partnership with Royal Brompton).

[Fortepiano in reply to Red_Baron]

You're in good hands then!