Hi Liam,
I read your post in the valve selection forum also. It is very understandable that you want to minimize the number of surgeries you will need to experience. But for someone with BAVD, more than the valve needs to be evaluated. An echo through the chest wall does not give an image of your entire aorta, which should be part of your work up. A CT or MRI with contrast will give pictures of the entire aorta.
You need to know the status of your aorta - root, ascending, arch, all of it! If you have an aneurysm, or any enlargement beyond what is normal for you as an individual, you need to know about it, and it needs to be part of the strategy both now and in the future.
There is no need to guess about where you are right now. It should be better today for those with BAVD than it was 17 years ago when my husband received a mechanical valve - meant to be the only surgery he would ever need. I know now that his aorta had already dilated at that time, but nothing was said. It took about 11 years for him to develop a large aneurysm. So giving him a mechanical valve, while well intentioned, did not prevent him from needing surgery again for the aneurysm. (Later, the mechanical also gave him a problem.)
How is your blood pressure? Does it spike with exercise and/or stress? This is called labile hypertension and often comes along with BAVD. It is an important thing to know and to get control over.
Perhaps this paper will be helpful regarding BAVD - it has some helpful pictures/diagrams.
http://circ.ahajournals.org/cgi/content/full/106/8/900
Best wishes,
Arlyss
