Hello! Thank you for asking on HCM! Regarding your concern, I would explain that as far as bicuspid aortic valve isn t associated wt aortic stenosis or significant aortic regurgitation, and he is clinically asymptomatic, surgery would not be an option to consider. The only care to be paid is prophylactic treatment for endocarditis before any invasive procedures in the future, and a periodic follow up by his attending cardiologist (physical exam and repeated cardiac ultrasounds). In general bicuspid aortic valve with time is complicated with aortic stenosis, regurgitation and sometimes aortic root dilation. That s why periodic cardiac ECHOs are necessary to timely detect any complications. Hope to have been helpful! Greetings! Dr. Iliri