One congenital valve. Two structures to follow.
Valve and aorta,
read together.
01FunctionStenosis or leak02MorphologyCusps and calcium03AortaRoot and ascending04StrategyNow and later
Your Incision Should Be Your Decision™
Bicuspid aortic valve second opinion
Review the bicuspid valve and the aorta before deciding what comes next.
A cardiac surgeon and cardiologist independently review your complete echo, CT or MRI, prior studies, and proposed plan—then explain how stenosis or regurgitation, valve morphology, root and ascending-aorta dimensions, and lifetime priorities shape the questions to discuss with your treating team.
- $495
- dual-physician written review
- 2
- independent physician reads
- 24 hr
- after complete records and imaging
No referral or travel required. Live physician consultations are optional and priced separately.
Valve and aorta,
A bicuspid valve decision can be about the valve, the aorta, or both. The review should say which.
Explore a sample reportSix parts of one decision
“Bicuspid” describes the anatomy. It does not decide the plan.
The same diagnosis can appear as a stable valve, progressive narrowing, significant leakage, an enlarged aorta, or more than one of these. A useful second opinion separates the problems before comparing paths.
Stenosis: how narrow is the valve?
The source echocardiogram, velocity, gradients, valve area, calcium, symptoms, ventricular response, and change over time help explain whether narrowing is driving the current conversation.
Regurgitation: how much does it leak?
Leak severity, cusp motion, root geometry, ventricular size and function, symptoms, and serial change belong together. A regurgitant valve raises different timing and repair questions than a stenotic valve.
The root and ascending aorta
The largest diameter is only the start. Location, measurement method, body size, interval growth, family history, coarctation, and whether valve treatment is already being discussed all add context.
Bicuspid morphology and calcium
Cusp-fusion pattern, raphe, leaflet quality, calcium distribution, annulus, coronary anatomy, and root shape can affect repairability and the technical context for replacement.
The rest of the heart
Ventricular function, coronary disease, another valve condition, rhythm history, blood pressure, kidney and lung health, prior procedures, and operative risk can change which questions belong in the same plan.
A lifetime—not only a procedure
Age, expected longevity, anticoagulation, future valve procedures, pregnancy plans when relevant, work, activity, recovery, and personal priorities deserve a place in shared decision-making.
Treatment paths, kept in context
Define the problem before comparing procedures.
Surveillance, surgery, and TAVR answer different questions. Their relevance depends on the valve problem, the aorta, the imaging, the person, and the plan already under discussion.
Surveillance
Some bicuspid valves and aortas are followed over time rather than treated immediately. The useful questions are what is being measured, how consistently, what has changed, and which symptoms or findings the treating team wants to hear about.
What does the serial record show—not just the latest report?Surgery
Surgery can address the valve and, when indicated, the aortic root or ascending aorta during the same operation. The discussion may include repair, replacement, prosthesis strategy, surgical access, and program-specific experience.
Is the proposed operation treating the valve, the aorta, or both?TAVR
TAVR may enter the conversation for selected patients with bicuspid aortic stenosis. CT-defined anatomy, calcium, annular shape, coronary relationships, age, lifetime strategy, and any aortic enlargement matter; TAVR does not repair an enlarged ascending aorta.
What does the actual CT say about feasibility and trade-offs?This service organizes educational context from the available record. It does not recommend surveillance, surgery, TAVR, or any other treatment.
The aorta above the valve
A measurement needs a location, a method, and a trend.
Echo, CT, and MRI may not measure every segment in exactly the same way. The review organizes what was measured, where it was measured, how comparable the studies are, and which clinical factors give the number meaning.
Body-size contextGrowth across comparable studiesFamily historyCoarctation and other anatomy
01Aortic root
Sinuses and root phenotype, including how the valve and root geometry relate.
02Sinotubular junction
The transition between the root and tubular ascending aorta.
03Ascending aorta
The maximal diameter, location, acquisition method, and comparison with prior studies.
04Arch and beyond
Additional thoracic-aorta findings when the clinical question or available imaging makes them relevant.
Repair versus replacement
Preserving the valve and replacing it are different lifetime strategies.
Repair is not possible for every bicuspid valve, and replacement is not one uniform choice. The review makes anatomy, durability, operator experience, and future consequences visible without selecting a procedure.
Repair
Repair may be discussed for selected bicuspid valves—most often when regurgitation, pliable leaflet tissue, cusp geometry, and root or annular anatomy make a durable reconstruction technically plausible. Suitability and durability are highly anatomy- and experience-dependent.
- What is causing the regurgitation?
- Does the source imaging suggest repairable leaflet and root anatomy?
- What repair-specific experience and follow-up does the proposed program have?
Replacement
Replacement opens a second decision about mechanical, tissue, or—when relevant—pulmonary-autograft strategies. Anticoagulation, durability, reintervention, pregnancy considerations, valve size, future coronary access, and the aorta belong in the same lifetime plan.
- What are the trade-offs of each valve strategy for this patient?
- Would the aorta be treated during the same operation?
- How could today’s choice shape a future procedure?
WHITEGLOVE Heart Team
The valve view and the aorta view belong in the same room.
The cardiac surgeon examines repair and replacement anatomy, the root and ascending aorta, combined operations, technical access, and operative context. The cardiologist examines longitudinal valve function, symptoms, ventricular response, imaging, medical context, and catheter-based considerations. Both read the same complete record and co-sign one report.
Meet the WHITEGLOVE Heart TeamWHITEGLOVE Insights™
One written map of the valve, the aorta, and the decision.
The report is written for patients and families, grounded in the complete source record, and signed by both reviewing physicians.
Download a sample reportTwo structures.
One clear
case map.
Valve functionStenosis · RegurgitationValve anatomyCusps · Raphe · CalciumAortic anatomyRoot · Ascending · TrendDecision contextTiming · Path · Lifetime
Cardiac surgeonCardiologist
The decision in front of you
The diagnosis, symptoms, serial testing, treating team’s plan, and the exact questions the review is meant to clarify.
Stenosis versus regurgitation
A plain-language explanation of which valve problem is documented, how severe it appears in the available record, and what remains uncertain.
Valve morphology and repair context
Cusp fusion, leaflet quality, calcium, root geometry, and the anatomical questions that may affect repair or replacement discussions.
Root and ascending-aorta map
Measurements are organized by location, imaging method, body-size context when relevant, and change across comparable prior studies.
Procedure paths in context
Surveillance, repair, surgical replacement, TAVR, and combined valve-aorta surgery are discussed only where the record makes them relevant.
Lifetime valve strategy
Durability, anticoagulation, future reintervention, coronary access, recovery, and the patient’s stated priorities are considered together.
Family-screening context
The report notes the family-history and first-degree-relative questions raised by bicuspid valve or associated aortic disease.
Missing records and next questions
Material gaps become a practical checklist for the next conversation with the clinicians responsible for care.
The complete-record milestone
A report is only as specific as the imaging behind it.
The records team helps identify what the physicians need for the question at hand. A missing study does not imply inadequate care; it means the limit of the available review should be stated clearly.
Source echocardiography
The actual echo images and report, including valve morphology, stenosis and regurgitation measures, ventricular size and function, and any visible aortic dimensions.
CT or MRI of the thoracic aorta
When performed or clinically relevant, cross-sectional imaging can clarify the root, ascending aorta, arch, coarctation, calcification, and dimensions not fully seen on echo.
Comparable prior imaging
Earlier echo, CT, or MRI studies help distinguish one measurement from a reproducible trend. Acquisition method and measurement location matter when studies are compared.
Clinical notes and symptom history
The treating cardiology and surgical assessments, symptom course, blood pressure history, medications, laboratories, and the proposed surveillance or treatment plan.
Coronary and procedural planning
Catheterization, coronary CT, TAVR-planning CT, operative notes, or other studies when coronary disease, prior surgery, or an intervention is part of the question.
Family and genetic context
Known bicuspid valve, aneurysm, dissection, coarctation, sudden unexplained death, prior genetic evaluation, and screening already completed in close relatives.
Family-screening context
One diagnosis can raise a reasonable question for close relatives.
The review can identify the family conversation raised by current guidance. It does not test, diagnose, or advise an individual relative; each person should discuss personal screening with their own clinician.
Who counts as first degree?
Parents, siblings, and children are first-degree relatives. Current aortic-disease guidance places echocardiographic screening for bicuspid valve and root or ascending-aorta dilation in the family conversation.
What if an echo cannot see the whole aorta?
CT or MRI may be part of a clinician-directed evaluation when transthoracic echo does not adequately show the root or ascending aorta. The right test depends on the individual.
Does every family need genetic testing?
No single rule applies to every family. Age at diagnosis, aortic disease, syndromic features, coarctation, and family history can shape whether genetic counseling or testing is discussed.
Evidence, interpreted in context
Valve guidance and aortic guidance answer different parts of the case.
ACC / AHA2020 guideline perspective on aortic stenosis, regurgitation, and bicuspid valveACC / AHA2022 aortic-disease guidance for bicuspid aortopathy and family screeningInternational consensusBicuspid valve and aortopathy nomenclature, phenotype, and imaging contextAATSConsensus guidance on bicuspid aortic valve–related aortopathy
Guidelines describe populations and clinical frameworks. They do not predict an individual outcome or replace interpretation by the treating physicians who know the patient.
How it works
From scattered imaging to one coherent conversation.
The 24-hour clock begins only after the records and imaging required for the case have been received and confirmed complete—not when a patient first requests records.
- 01
Start with a complimentary orientation
Tell a Heart Team specialist what you were told and whether the unresolved question is the valve, the aorta, timing, or the operation proposed. No referral or records are required for this first conversation.
- 02
Complete the record and imaging
Upload what you have or authorize the records team to help identify and request the echo, CT or MRI, prior comparisons, notes, and other materials needed for the review.
- 03
Two physicians review independently
A cardiac surgeon and cardiologist examine the same complete record from different clinical perspectives, then confer.
- 04
Receive one co-signed written report
Your WHITEGLOVE Insights™ report is delivered within 24 hours only after the records and imaging required for your review have been received and confirmed complete.
Written clarity first
The complete written review is $495. Conversation is optional.
Every tier includes the same two independent physician reads and co-signed report. Choose a live consultation or concierge access only if that additional support fits your decision.
WHITEGLOVE Insights™
$495The dual-physician medical-record and imaging review with one co-signed written report. No live consultation is required.
WHITEGLOVE Consult
$995The written review plus a live consultation with one of the reviewing physicians.
WHITEGLOVE Heart Team
$1,495The written review plus both reviewing physicians together on the live consultation.
WHITEGLOVE Concierge
$2,495The Heart Team consultation plus concierge access until the day of surgery.
Direct pay. WHITEGLOVEMD does not submit an insurance claim. Record-collection time is outside the 24-hour complete-review window.
Bicuspid aortic valve second opinion FAQ
Questions patients and families ask before the next scan—or the next procedure.
What is a bicuspid aortic valve second opinion?+
It is an independent review of the records and imaging behind a bicuspid aortic valve decision. The review can organize valve morphology and function, stenosis or regurgitation, the aortic root and ascending aorta, change over time, the treatment or surveillance plan proposed, and the questions that remain. It does not diagnose or choose treatment for you.
Does a bicuspid aortic valve always require surgery?+
No. Some bicuspid valves function well and are monitored, while others develop stenosis, regurgitation, or associated aortic enlargement that may lead to a treatment discussion. Symptoms, valve severity, ventricular response, aortic dimensions and growth, other health conditions, and the complete clinical context all matter. Follow the surveillance and urgent-care instructions from your treating team.
What is the difference between bicuspid aortic stenosis and regurgitation?+
Stenosis means the valve has become too narrow for blood to leave the heart normally. Regurgitation means the valve does not close completely and blood leaks backward. A patient can also have mixed disease. The measurements, effects on the heart, timing questions, and procedural options are not identical, so the review separates them rather than treating “bicuspid” as one uniform problem.
Why do the aortic root and ascending aorta matter?+
Bicuspid aortic valve can occur with enlargement of the aortic root or ascending aorta. That may affect surveillance, imaging, and the scope or timing of a surgical conversation, especially when valve treatment is also being considered. A useful review identifies where each measurement was taken, how it was obtained, whether body-size indexing is relevant, and how it compares with prior studies.
Can a bicuspid aortic valve be repaired instead of replaced?+
Some bicuspid valves may be considered for repair, particularly selected regurgitant valves with favorable leaflet and root anatomy. Repairability and durability depend on the mechanism of leakage, tissue quality, cusp geometry, aortic anatomy, and repair-specific surgical experience. The review can explain whether repair deserves discussion based on the available imaging; the treating valve team determines candidacy.
Can TAVR be used for a bicuspid aortic valve?+
TAVR may be considered for selected patients with bicuspid aortic stenosis, but bicuspid anatomy requires individualized evaluation. CT findings such as calcium pattern, annular shape, coronary relationships, and aortic dimensions, along with age, surgical risk, longevity, and future-procedure planning, affect the discussion. TAVR does not repair an enlarged root or ascending aorta and is not a treatment for every form of bicuspid valve disease.
Will the review compare mechanical, tissue, and Ross options?+
When valve replacement is relevant, the report can organize the documented trade-offs among mechanical and tissue prostheses and, when clinically appropriate to discuss, a pulmonary-autograft or Ross strategy. Durability, anticoagulation, bleeding and clotting considerations, pregnancy plans when relevant, reintervention, anatomy, and program experience may all matter. The service does not select a valve or procedure.
What imaging is needed for a bicuspid valve second opinion?+
The exact record depends on the question. It commonly includes source echocardiogram images and reports, prior comparable studies, and CT or MRI when the thoracic aorta or procedural anatomy needs clarification. Clinical notes, symptom history, laboratories, catheterization or coronary imaging, and the proposed plan may also be relevant. The records team can help identify what is needed after authorization.
Should family members be screened for bicuspid aortic valve?+
Current aortic-disease guidance places screening of first-degree relatives—parents, siblings, and children—with transthoracic echocardiography in the clinical conversation for bicuspid valve and associated root or ascending-aorta dilation. CT or MRI may be used when echo assessment is incomplete. Each relative should discuss personal screening with their own clinician; WHITEGLOVEMD does not order or interpret family screening through this service.
Who reviews my bicuspid aortic valve case?+
A cardiac surgeon and cardiologist independently review the same complete record and imaging, then confer and co-sign one WHITEGLOVE Insights™ report. Both physician perspectives are included in the $495 written review. A live consultation is optional and costs extra.
How quickly is the written report delivered?+
The written report is delivered within 24 hours only after the records and imaging required for your review have been received and confirmed complete. Time spent identifying, requesting, transferring, or collecting records is outside that 24-hour window.
How much does a bicuspid aortic valve second opinion cost?+
The WHITEGLOVE Insights™ dual-physician written review is $495. Live consultation tiers are optional: WHITEGLOVE Consult is $995, WHITEGLOVE Heart Team is $1,495, and WHITEGLOVE Concierge is $2,495. The service is direct pay, and WHITEGLOVEMD does not submit an insurance claim.
Does WHITEGLOVEMD replace my cardiologist or surgeon?+
No. WHITEGLOVEMD provides educational decision support and independent medical-record review. It does not establish a treating relationship, diagnose, prescribe, order testing, select a procedure, provide emergency care, or replace the clinicians responsible for your care. Do not delay urgent or time-sensitive treatment while seeking a review.
Not emergency care.
Do not delay urgent or time-sensitive evaluation or treatment while waiting for WHITEGLOVEMD. If you may be experiencing a medical emergency, call 911 immediately.
The decision stays yours
Before choosing a path, make sure the valve and the aorta are both in the picture.
Start the dual-physician written review for $495, or begin with a complimentary orientation. Live consultation is optional.