Dr. Creswell We are wondering is there a science to knowing when he should have the surgery? Congenital heart issues affect approximately 40,000 people born each year in the U.S. and are one of the most common types of birth defects. Doc says no problem, but that seems to be contrary to what I see here. Both are important in deciding if and when operation is needed. Bicuspid aortic valve is a common congenital anomaly but does not cause functional problems unless aortic valve stenosis, aortic valve regurgitation, aortic root dilatation, or dissection or infective endocarditis occurs. So my question: does there appear to be any performance advantage of tissue valves over mechanical or does the fact that Im on the anticoagulant anyway make the mechanical valve sort of a no brainer choice? Ten years ago (2006), doctors said that there was a worsening of the BAV but still no need to have Aortic replacement. The reason I ask is my Cardiologist said it looked fine in the echo imaging, but (and correct me if Im wrong please) I got the impression from what you said in this article that a CT or MRI is necessary for aortic diameter measurement. It has allowed me to do the thing I enjoy doing in life. In March 2018 he underwent emergency surgery to have this replacement valve replaced. Bicuspid aortic valve (BAV) and congenital aortic stenosis are two types of heart defects that may be present at birth. Looking through the reader comments here at the blog and reflecting on the athlete inquiries Ive received, I thought Id cover some of the major issues. (Have you heard of the studies by Dr. My average weekly training plan includes 50k of running (5 days) with 80% done on pulse below 154-152 and only 20% done at pulse about 175-179 bpm. Use or viewing of any Baldwin Publishing, Inc. article signifies your understanding and agreement to the disclaimer and acceptance of these terms of use. 3. Periodic re-evaluation with echocardiogram and/or CT scanning is used for most patients in this circumstance. I had my AVR almost one year ago. In fact, in some people they can go undiagnosed for years. And of course the problem occurs in everyday, recreational athletes, too. BAV is the most prevalent congenital heart defect, but can go undetected for years - even into adulthood. Enlarged ascending aorta 42-43 mm Arnold Schwarzenegger (The Governator) - Heart Valve Replacement. Normal great vessel size The fusion (sticking together) of the valve leaflets causes abnormal valve opening and closing. Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. Aortic valve stenosis: Your aortic valve narrows, reducing blood flow through it. The incidence of bicuspid aortic valve and complications. Have you considered meeting with a heart surgeon to talk about the situation? Ive seen several cardiologist and they are divided in recommendations. Thank you for your expert opinion. Thank you for the follow-up! Weve known the risks and my daughter has done well to avoid scrapping for the ball etc. Another possibility that you havent mentioned deserves some discussion with your sons doctor(s) or surgeon. My question is if my weight&lack of training or my BAV is the cause of difficulty in running. The current guidelines suggest that sports activities do not need to be restricted for patients with BAV who have no valve regurgitation/stenosis and who have no enlargement of the nearby aorta. I look forward to hearing from you. However, I absolutely love being competitive at running, and dont want to jeopardize that either. Susp. They are able to see my son this Friday, which i am much more comfortable with! I am a marathoner with BAV and no other cardiac issues. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. Your doctors will be in the best position to offer advice because they will be most familiar with your case. What does heavy weights mean? 3 In the most common type (type 1), there is a fusion line between the left and right coronary cusps, which extends a variable distance from the commissure (the point of attachment of the . You can contact me on zdenkokosutic@yahoo.com. Is a CT or MRI absolutely necessary for measuring the aortic diameter? Elite triathletes and heart problems I have also been advised that running intervals at over 80% max heart rate would not be sensible. Use of this site constitutes acceptance of our User Agreement and Privacy Policy and Cookie Statement and Your California Privacy Rights. I take BP medication namely Amlodopine & Ramipril which has lowered my BP. In the 2.5 years from surgery, I returned back to riding within the first 3 months and later back to longer, decent training pace rides and racing but feel like I have lost my top end mojo. since the last worsening ten years ago, the situation still stable and each year I went to the doctor to have the tests, they still tell me nothing has been changed since. On the bright side, there is ample evidence that, in the modern era, life-expectancy is not shortened for individuals with BAV compared to the general population. Always best to heed the advice of your doctor(s) who will be in the best position to offer advice about safe forms of exercise. I am healthy, strong, and active. I asked her when I get my valve replaced(it will have to be replaced sometime in the future) will they repair my aneurysm and to my surprise she said no. My questions are: The other theory is that there is a structural problem that leaves the aortic wall weak. I am wondering if you know anything about these drugs and how they can impact aortic growth? Last week I visited a doctor and here are the changes for the last year (before|after): Many thanks. Unfortunatly that`s pretty much all the advice i`ve been given so far, so little out there on what i can actively do and what i can`t. What activities can I do? I cant wait to be back, completely rested with my heart recharged, my passion for the work ahead purposeful and my joy at lifes pleasures high," the statement continued. Echo Features of a Bicuspid Aortic Valve | 123 Sonography I dont know about the relative effectiveness of various ARBs used for this purpose. I have recently had CT scan and MRI scan, following some chest pain experienced on track while doing marathon training. You already have a cardiologist looking after you. I found myself in emergency surgery 12 months ago with 50% leakage, an enlarged heart and an ejection fraction of 30. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . My questions are For athletes who return to sport after AVR and aortic replacement, its important to settle on whats safe with your doctor(s) ahead of time. Monica Lewinsky: 25 Randoms on the 25th Anniversary of the Bill Clinton Calamity. Some good points there, Craig. Bicuspid aortic valve (aka BAV) is a form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a two-leaflet (bicuspid) valve instead of the normal three-leaflet (tricuspid) valve. (Or do I just need to train even harder??). This valve repair option is one that might best be pursued at a center that specializes in this problem. John Ritter - Actor - passed away due to undiagnosed CHD at age 55. Aortic valve repair and aortic valve replacement are done to treat aortic valve disease. Im not sure theres enough information at hand to offer sound advice. Anyway, I will continue with running as much as I can, and now I have an excuse for my lousy performance. Adam has been featured by the American Heart Association and Medical News Today. Advances in treatment have allowed many babies with known congenital heart disease to survive well into adulthoodand many people who have congenital heart disease go on to live long, productive lives. His aorta is lightly enlarged. 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I have been factual with him and told him worst case scenario is he is done with both and have pushed him to see the positives of exploring other things to do. After his procedure, Arnold posted the picture above with the following statement, "Thanks to the team at Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery. However, my surgeon told me that he could fit a tissue valve and so would not need to be on warfarin. I dont know all of the important details. I am a competitive cyclist, neither the Cardio or my Doctor said I should not be racing bikes anymore, does that sound reasonable to you, my doc did say to monitor the aortic root size yearly. Have tried to get a personal trainer that specialises in all things heart related here in the UK but there don`t seem to be any around despite searching. Arnold Schwarzenegger Helped Greta Thunberg Get a Tesla, Where to Watch the Biggest 2023 Awards Contenders. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. Just double checking. An article at Endurance Corner about Normann Stadler, A blog post about elite triathletes and heart problems, Aortic stenosis and bicuspid aortic valve (BAV), http://www.athletesheart.org/wp-content/uploads/2013/12/Classification-of-Sports-300217.png, https://academic.oup.com/ejcts/article/50/3/400/2197426, If there is enlargement of the beginning portion of the aorta to greater than 4.0 cm, the individual should have a. Practice Essentials. The free weights are about 10kg and Im not doing any really heavy weights. I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. Search Hospitals, Join 375,000+ Patientsat Our Facebook Page Click here, HeartValveSurgery.com 2785 Pacific Coast Hwy, #517 Torrance, CA 90505 Phone: (888) 725-4311, 2023 HeartValveSurgery.com. I know what theyre saying and after that I know that I have mixed feelings because I feel depressed about not being active like I used to be, but then I feel selfish as I am not being grateful. The doctor said she would see if she could talk about his case with the surgical panel but she said even if he did have surgery he couldnt have a career in sports??? To me, cardiologists are not sports people and air on being absolutely over cautious. In your experience, can patients with BAV go a lifetime without having AVR? The idea of somehow restricting the HR may be attractive as a means of curtailing strenuous activity. E. G. I could bench 50lbs with no need to strain and hold my breath, which wouldnt result in a massive spike in blood pressure, but if I tried to bicep curl 50lbs it would do. Substitute valves. Keep us posted! Bicuspid Aortic Valve: Symptoms, Diagnosis & Treatment, Biological Tissue Valves: Pig, Cow, Horse & Human, The Patient's Guide To Heart Valve Surgery. Bicuspid valve stenosis treatment involves surgery to replace the valve. In late March, Schwarzenegger was heavily involved in a chess tournament with his donkey Lulu. 1. Very often, the specialists office will make note of the patients problem and make appropriate decisions about whether routine or urgent appointment scheduling is needed. In addition to this public search, we scanned our proprietary research database of over 1 million sources and were unable to find any specific research reports that address your goals. For those with moderate aortic stenosis, the guidelines suggest restricting activities. Dear Dr. Creswell, Rather than just sit there and do nothing about how much I missed [my mother], I put all of that pain, sorrow and longing for my mother into helping educate and make people aware. My cardiologist is not concerned. After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets? The cardiologist told us at that appointment that we needed to start considering surgery to repair his valve. I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. While I do expect to have a replacement done later in life, the repair was the best decision I could have made. mod-severe regurgitation Im paranoid to exercise too much for fear that I will do damage to the valve. We generally limit weight-lifting (or other sports/exercise that have a high static component) for athlete patients with BAV and mild enlargement of the aorta. March 7, 2023, Rob Riley The numbness/tingling has me constantly worriedand the slight chest pains have me always thinking is that my BV or Aorta causing issues?. Its very helpful for people with heart problems. Thank you for this blog! The procedure was performed at the Cleveland Clinic. I had surgery when I was 10 years old to replace my bav with a St.jude mechanical valve. Anyway, talk to a surgeon who understands quality of life means. Perhaps a cardiac surgeon would be able to provide even more detailed information about things like various options for operation that might be applicable in your case as well as thoughts about when operation should be performed. His doctor said his heart look very healthy and no other issues. If you havent yet seen a surgeon, perhaps a visit would all wan opportunity to talk about these issues, even if operation is not yet needed. Anyway, it has slowed to 1 mm per year, and, via email, Dr. Dietz has suggested we may consider a switch to 300 mg Libersartan? These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. The surgery involved a replacement heart valve made from a transplanted tissue sourced from his pulmonic valve. 1. You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. Thanks so much for all this info! My son is a baseball player, so that is good. Im 31 and 1 years ago i found im BAV with modrate AI. Negative Stress Echocardiography And he never had any symptoms and played competitive soccer since he was 6. This procedure has the particular benefit that no artificial valve (with the disadvantages described above) needs to be used. Theres no reason to not be CPR certified.. Some information about myself: Im 28, 186 cm, 77 kg, max pulse 194, rest 50 bpm, live in Russia. Aortic Stenosis First, a disclaimer.My practice is devoted to adult patients. I seen my cardiologist yesterday and this is the first year in 4 years that the aneurysm hasnt grown a mm. 2. She was originally under the impression she felt the way she did simply because she was exhausted. Hey would like to continue to be active but is worried about which procedure would be best for him. ANYTHING other than walking and golf? with valve area of 1.4 cm2 and aorta of 4.1 cms Ever since undergoing open heart surgery in 2010 for her surprise diagnosis of heart disease, Jones has worked as a national ambassador for the American . Its really not strenuous, maybe 10 km/h and not more that 10 push ups at once. that suffer from heart valve disease along with a link to the reference story about their heart valve disease and their Twitter handle can be found below: ), the famous American television anchor, suffers from, ), the Olympic Gold Medalist (Soccer) suffered from, ), a comedian and broadcaster, suffers from a. Dr Creswell, The valve may also become stiff due to calcium deposits on the leaflets over time. A 2019 report suggests that bicuspid aortic valve disease is the most common congenital heart valve problem, affecting between 0.5 and 2 percent of the general population. Good to hear that youre doing well. Im due to have an exercise tolerance test soon, but from my dealings so far Ive lost faith in the level of competence of my current cardiologist. Bicuspid aortic valve is associated with abnormalities in the coronary artery anatomy in about 2% of patients, including anomalous origins of the coronary arteries and upwardly displaced coronary ostia. In Jan 2016 My son was seen by the cardiologist and had some changes on his echo and the cardiologist said hey had mild progression of the aortic regurgitation( moderate to severe) with preserved LV function. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. Although the vast majority in each group (97%) underwent TAVI via the transfemoral approach, bicuspid patients were less likely to receive conscious sedation (57% vs 62%) and more likely to be treated with the largest 29-mm valve size . Is there anything we can do? Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. Arnold Schwarzenegger Was Born with a Valve Defect - AmoMama It is unclear however if there are cardio thoracic surgeons who perform minimally evasive repairs yet. Crossref Medline Google Scholar. My questions are: can my root dilation remain stable? Search Heart Hospitals Related posts: Now, fully healed thanks to two stents in her arteries, Lucci is spreading the word. I am a 48yo competitive cyclist who is very concerned with being able to return to my former ability to hit high effort levels following open heart surgery. All they said is dont really do weight where you can feel the strain in your neck ?!? Likewise, if I did a 60kg bench press I could easier than say an 18 year old girl started at the gym tried that, they would have to strain beyond belief. which seems to suggest that he has returned successfully to the sport. Body contact sports may pose some danger to athlete patients who take blood thinners. I did cardio training 3 times a week and weight training twice a week for 60 years. I love running. An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent . It functions as a one-way valve, opening and closing with each heartbeat, which keeps the blood flowing in the correct direction. will need careful consideration by your physicians who know all of the pertinent details. I dont believe this has been well studied. Since my initial post i decided to call another pediatric cardiology hospital in our state, University of Michigan Pediatric Cardiology. The important considerations in athletes with BAV are the degree of regurgitation of the valve and the degree of enlargement of the aorta. I had a good childhood being very active in sports and physical activity, I had just had to watch out for contact due to warfarin. My question here is what is the damage I can cause to my heart, mechanical valve, if I keep my heart rate at hi intensity levels? Any words you have for us would be greatly appreciated. He wasnt real worried about me and I have regurgitation (mild) and (mild) aortic root dilation.. Do u think it would be OK to lift weights and if so maybe u could give me a better understanding. Your sons doctors are undoubtedly experts at pediatric patients. The issues related to repeat aortic valve surgery, with or without replacement of the aorta, are complicated. Options for operation I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. We saw cardio in April again and my sons symptoms are the same and no progression on the aortic regurgitation. His only complaint or change is shortness of breath with stairs. He just turned 15 he is 511 203 lbs and has a heart of gold. Q And A: What is a bicuspid aortic valve? - Medical Xpress In large-scale pre-participation cardiac screening programs for young, competitive athletes, BAV is one of the most commonly identified abnormalities. Schwarzenegger visited USC on April 16, 2007 and saluted the new Cardiovascular Thoracic Institute (CVTI), according to a press release issued by The Keck School Of Medicine at USC. The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve A bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in approximately 1%-2% of the general population. The guidelines do not address the frequency of surveillance for individuals with BAV and no enlargement of the aorta. Many athletes with bicuspid aortic valve (BAV) may continue to participate in their sports.provided there are no other problems, either with the aortic valve or nearby aorta. Questions about Bicuspid Aortic Valve!! : r/AskDocs I have appointment with a cardiologist on Friday but in the meantime i would like to know weather in case of surgery a replacement of the valve is definitely necessary or my condition still allows some options for a surgery without replacement. It's the most common type of congenital heart disease (heart defect that's present at birth) and often goes unnoticed until later in life. Do medications like beta-blockers limit any potential harm? I have repeatedly asked each follow up, if continued marathon training is OK. Im always told it is fine with the old adage of listening to your body. Aortic Valve: Function, Location & Anatomy - Cleveland Clinic Symptoms of bicuspid aortic valve disease most commonly develop in middle age in people with a history of a childhood heart murmur. This year (her junior year) her Cardio doc is saying that she cant in good conscious clear her for basketball (the sport my daughter LOVES). And judgment would be needed. Thanks so much My 25 year old son was just diagnosed with BAV AR (3+). Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised.
