bivalvular

Bivalvular is an adjective used in medical contexts to describe something relating to two valves. In cardiology it is most commonly encountered in two settings: anatomy and disease.

In anatomy, the term often appears in reference to valves with two leaflets, most notably the bicuspid aortic valve, an uncommon congenital variant in which the aortic valve has two cusps instead of three. Bicuspid valves may be solitary findings or associated with aortopathy, including enlargement of the ascending aorta and risk of dissection. Most individuals with bicuspid aortic valve remain asymptomatic for years, although some develop stenosis or regurgitation.

In disease, bivalvular disease refers to pathological involvement of two cardiac valves, frequently the mitral and aortic valves, though any two valves may be affected. Rheumatic heart disease historically is a common cause, but degenerative, ischemic, or infectious etiologies can also yield two-valve involvement. Clinical presentation depends on the affected valves and can include dyspnea, fatigue, edema, or signs of heart failure. Diagnosis relies primarily on echocardiography, with CT or MRI providing anatomic detail or assessment of the aorta when appropriate.

Management is guided by severity and underlying cause. Medical therapy addresses heart failure symptoms and rhythm or blood pressure control; definitive treatment typically requires valve repair or replacement. In bicuspid aortic valve, monitoring of the aortic root and ascending aorta is advised due to associated aortopathy. Infective endocarditis prophylaxis may be indicated in certain contexts.