Final answer:
Regular echocardiography is essential for monitoring bicuspid aortic valve with dilated aorta, leading to surgery when certain thresholds are met. Surgical options include valve replacement or repair, and post-operative care may involve prophylactic antibiotics.
Step-by-step explanation:
Surveillance for a bicuspid aortic valve with a dilated aorta should be personalized to each patient, but generally includes regular echocardiography to monitor the size of the aorta and the function of the bicuspid valve. This monitoring can occur on an annual basis or more frequently if the aorta is approaching surgical dimensions or if there are changes in clinical symptoms. The decision to operate is usually based on the size of the aorta (with thresholds of 5.0-5.5 cm often used), the rate of aortic dilation, the presence of symptoms, and other individual risk factors.
Patients with aortic stenosis often experience a progressive worsening of the condition. When signs of significant valve obstruction or heart dysfunction arise, such as worsening heart failure symptoms or evidence of a significant decline in the heart's pumping ability, surgical intervention becomes necessary. This can include aortic valve replacement or repair, which may be done through traditional open-heart surgery or less invasive methods, such as transcatheter aortic valve replacement (TAVR).
As part of post-operative care and to decrease the risk of infection, some patients, especially those at higher risk, might require ongoing prophylactic antibiotic treatment, such as what is recommended by the American Heart Association.