More testing cmr, chest ct, transesophogeal echo, caths, should be done if he is symptomatic ( short of breath, palpatations etc.), or if the echo shows dysfunction ( like large amounts or regurgitation).
I'm not sure I understand your question. We all have 4 valves, but sometimes an indiviudal may have 2 leaflets instead of 3 leaflets with the aortic vavle. The aortic valve is a one-way valve between the heart and the aorta, the main artery from the heart that distributes oxygen-rich blood to the body. Normally, the aortic valve has three small flaps or leaflets that open widely and close securely to regulate blood flow, allowing blood to flow from the heart to the aorta and preventing blood from flowing backwards into the heart.
In bicuspid aortic valve disease (BAVD), the valve has only two leaflets. With this deformity, the valve doesn’t function perfectly, but it may function adequately for years without causing symptoms or obvious signs of a problem.