The majority of bicuspid valves are well tolerated throughout adult life, but individuals harbor a risk for bacterial endocarditis and antibiotic prophylaxis is required. The diagnosis of bicuspid valve is simple: a murmur is easily heard at the stethoscope in the aortic valve area and the second right intercostal space. The murmur may radiate and may be heard over the neck vessels. Echocardiography confirms the diagnosis.
A. Management and Research Implications
During young adult life the aortic valve may become obstructed or incompetent and must be replaced. The valve has a predilection for calcification which further obstructs the flow of blood. A mechanical valve is superior to a bioprosthetic valve that may only last 12–20 years. A pulmonary autograft, an aortic homograft, or other device may be selected depending on the age of the indi¬vidual and the preference of the surgical team.
Further research for new valvular structures that are long-lasting but carry no risk of thrombosis is needed.

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