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Arnold Schwarzenegger, a multifaceted personality, has faced significant health challenges that have shaped his life beyond Hollywood. Among many health challenges is a congenital heart defect known as bicuspid aortic valve (BAV), a condition that has necessitated multiple surgeries and a lifelong commitment to health management.
By openly discussing his experiences, Schwarzenegger has raised awareness about BAV. While the journey of Arnold serves as an inspiration, our expert, Dr Prashant Pawar, Consultant Interventional Cardiology, Fortis Hiranandani Hospital Vashi, offered more details about the bicuspid aortic valve (BAV).
What Is Bicuspid Aortic Valve (BAV)?
-1734610127517.jpg "Bicuspid Aortic Valve (BAV)?")
According to our expert, Dr Prashant Pawar, the bicuspid aortic valve (BAV) is a congenital heart defect where there are only two aortic leaflets instead of three. Detailing about the condition, he said, “Genetics plays an important role in BAV, as it is present from birth and can go unnoticed until diagnosed later in life. The global incidence rate of BAV is 1-2 per cent, whereas Indians have a higher incidence rate with approx. 2:1 male-to-female ratio.”
BAV is associated with heart conditions such as aortic stenosis, aortic regurgitation, dissection of the aorta, and infective endocarditis affecting the blood flow from the heart to the aorta. Over time calcification and fibrosis of the aortic valve can lead to stenosis (narrowing) and regurgitation (leakage) in the aorta.
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What Are Symptoms Of Bicuspid Aortic Valve (BAV)?
The symptoms of bicuspid aortic valve (BAV) typically arise when the valve begins to malfunction due to stenosis (narrowing) or regurgitation (leakage). Dr Pawar emphasises that regular monitoring is essential for asymptomatic cases to detect complications early. According to him, the symptoms usually vary as per the age group.
- Infants and children: Bluish skin (cyanosis), feeding issues, or failure to gain weight.
- Adults: Chest pain, tightness, breathing difficulty, fatigue, dizziness, fainting, and heart murmur (abnormal heart sound ).
How To Diagnose BAV?
The diagnosis of bicuspid aortic valve (BAV) primarily involves a comprehensive evaluation. It includes a combination of patient history, physical examination, and advanced imaging techniques. The most critical tool for diagnosing BAV is the 2D echocardiogram, which reveals the presence of two valve leaflets instead of the normal three. This imaging technique uses sound waves to create detailed images of the heart's structure and function, allowing healthcare providers to assess blood flow through the heart and evaluate any associated abnormalities.
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What Is The Treatment Of Bicuspid Aortic Valve (BAV)?
In terms of treatment, medications are used to relieve symptoms e.g. beta blockers and diuretics to manage fluid overload. Valve repair or replacement surgery can be an effective treatment for BAV. The replacement can be done through two types one can be open heart surgery and the other can be a less invasive keyhole procedure TAVR.
Open-heart surgery involves a large incision in the chest to directly access the heart. The damaged valve is removed and replaced with either a mechanical or biological valve. While effective, this method typically requires a longer recovery time and carries higher risks.
On the other hand, transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure suitable for patients at higher risk for traditional surgery. It involves inserting a new valve through a small incision, often in the groin, using catheters guided to the heart. This approach reduces recovery time and minimizes trauma to the body.