Bicuspid aortic valve

----think beyond the valve. It's really a disease of the entire aorta. From the review:

A more recent study has looked at the incidence of aortic complications in 416 BAV patients (mean and median age 35 years, range less than 1–89) [32]. Incidence of aortic dissection was found to be 1.5% in all patients regardless of the progression of BAV; however this increased markedly in patients aged 50 or older at baseline to 17.4% and even more in those found to have aneurysm formation at baseline to (44.9%). 25-year rate for aortic surgery was 25% and there was a significant burden of progression of disease to cause aortic dissection with 49 of the 384 patients without baseline aneurysms developing them during followup, giving an age-adjusted relative risk of 86.2 and an incidence of 84.9 cases per 10000 patient-years.