Bicuspid Aortic Disease | Cedars-Sinai However, many people will develop complications from their BAV and may need surgery in their lifetimeeither to repair or replace the aortic valve, the thoracic aorta or both. Bicuspid Aortic Valve - Symptoms, Diagnosis, Treatment & Surgery All Rights Reserved. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports. Thank you so much for your reply. I have only played a few games of football in the last 5 years due to a knee injury but I have continued running for fun and do 5k in a reasonable 25 minutes. Im a 30 year old male who is currently living in Asia with family. Aortic valve replacement is recommended for nearly all patients with severe valve stenosis (valve opening less than 1.0 cm2), Aortic valve replacement is recommended for patients with severe valve regurgitation if there are symptoms due to the regurgitation (eg, shortness of breath with exertion) or evidence that the heart is suffering because of the regurgitation (enlargement of the left ventricle), Repair or replacement of the beginning portion of the aorta is recommended if there is enlargement of the aorta to greater than 5.0 cm. Thank you very much for your answer. For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. This might reasonably translate into some measurable improvement related to physical exercise. CT or MRI may be more accurate. Finally, many patients are able to return to their sports after successful operation. I have moderate to severe regurgitation and the heart is enlarged as far as I understood. Guidelines suggest that athletes with BAV, normal size aorta, and no more than mild aortic regurgitation or stenosis can participate in all sports, without restriction.provided that they do not have an inherited connective tissue disorder like Marfan's's syndrome. The surgery involved a replacement heart valve made from a transplanted tissue sourced from his pulmonic valve. Normal function of cardiac valves The doctor allows me to do moderate sport defined by her like not 20k each day; 20k per week should be fine. I am now down to seeing my doctors every 3 years or so and have been doing very well. Post 2 years and Ive yet to get back to my high level of racing fitness and wanted to see what should be expected. To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. Just double checking. host, 76, suffered a mild heart attack in 2012. Thanks for the article! We briefly talked about the Ross procedure vs mechanical valve replacement. I suspect it had been leaking for a long time, as I felt no different; however, my recovery from long runs took longer than in the past (old age?). We also sign a school waiver every year. . Adam has been featured by the American Heart Association and Medical News Today. Hi again Dr. Creswell, From your reading, or even just here at the blog, youll know that its not an unusual story. In patients needing valve replacement because of stenosis or regurgitation, the aorta should be repaired or replaced if the aortic diameter exceeds 4.5 cm. Aortic dilatation is a common feature of BAV with a prevalence ranging from 20 to 84% , due to differences in assessment techniques, study population, aortic size thresholds, and heterogeneous nature of the . All severe aortic stenosis patients who are experiencing symptoms should ask for a TAVR evaluation. If youre questioning the recommendations youve received, perhaps a second opinion might be helpful. No information provided by Baldwin Publishing, Inc. in any article is a substitute for medical advice or treatment for any medical condition. Arnold Schwarzenegger says he feels 'fantastic' after - CNN Average STS score was 1.7%. What should I do ? Thoughts. 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. Athletes with BAV who have no stenosis or regurgitation of the aortic valve AND have no enlargement of the nearby aorta may participate fully in their sports. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. Celebrities with congenital heart disease Can you direct us to ANY research on the effect of endurance sports on AVR patients? How severe are the problems? Thats about as specific as he got. The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. Heart failure, where the heart weakens from working too hard to pump blood. The bicuspid aortic valve opens and closes abnormally, and can result in leaking of the valve. Dr. Larry, thank you very much for your blog! We just saw them in January. Im used to long runs up to 12 miles at an average 6 minute per mile pace as well as fast interval and farther training. Dr Creswell, Push for earlier date? I appreciate your response, thank you for taking the time to write me back. Hi. Will I need meds? Athletes with mechanical or bioprosthetic heart valves may participate in low and moderate intensity sports, Athletes who are taking blood-thinning medications should avoid sports where bodily injury, with potentially life-threatening bleeding, might occur. Would this constitute as too much in your opinion ? Ive seen several cardiologist and they are divided in recommendations. Negative Stress Echocardiography A bicuspid aortic valve (BAV) is an aortic valve that has only two leaflets instead of three. My problem is with cardiologists stating do not lift anything over 50lbs. Because it was just a cardiologist, not a sports cardiologist or physiotherapist. About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. Before that, I had never seen a cardiologist ever. Thank you for the blog that addresses the athletes point of view, and feelings. Celebrities With Heart Disease - Celebrity Heart Health Survivors And now my aortic root is 42 mm. Hi . Patients need operation if there is severe stenosis or regurgitation of the aortic valve.or if the nearby aorta becomes moderately enlarged. So, my question then is really, what should I look out for? Valvular Heart Disease | cdc.gov I realise that I will eventually need the valve replaced again and just hope that things go as well next time. The surgery was a full success, and the valve is closing really well now. Thats the main reason for choosing a tissue valve in my case. I am wondering because I know that weighlifting with bav isnt so good I feel terrible because i lov weightlifting and I have build a body that is so difficult for a 18 years old. Although bicuspid aortic valve is typically asymp tomatic at fi rst, it is commonly associ-ated with progressive valvulopathy and tho-racic aortic disease. I like to practice MTB and running competitively in local races. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. Additional types of patients who should ask for a TAVR evaluation include: Bicuspid aortic valve patients who are experiencing symptoms. Next year I would like to finish my first marathon but now I dont know whether I should keep running. I had AVR exactly 1 year ago to the date. Today at my hospital, we do most 1st time aortic valve replacements for aortic stenosis (narrowing) this way and have started using TAVR for patients with previous AVR using tissue valves who need re-replacement. Having a congenital heart defect means you are born with a problem with the hearts structure. Aortic valve diseases in pregnancy - European Society Of Cardiology Thank you to every doc and nurse on my team.". It sort of flutters open and shut. I made appointment with my cardio, to clear that up, dont worry :). Theres no reason to not be CPR certified.. PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. Its not around incision, its mainly middle of left side. Options for operation Your sons cardiologist would seem to be in the best position to offer specific advice. When the aorta is enlarged in the setting of BAV, there are a couple possibilities: the valve needs to be replacedor it doesnt: Valve repair. Yesterday, for example, I spoke with a 71-year old patient who just had aortic valve replacement surgery due to this . Do you think the jiu-jitsu (e.g. Do you think I should slow down a little bit? A bicuspid aortic valve (BAV) is the most common congenital heart defect, occurring in approximately 1%-2% of the general population. Would you recommend taking beta-blockers at this stage? Search Heart Hospitals Together, you should be able to settle on what sports activities will be safe based on those facts. Apparently this can work better than Losartan? I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Aortic root is 4cm and currently waiting for a 6month check up to see how it`s going. ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. Im 37 years old male, live in Croatia, 191 cm, 94 kg, very athletic, practicing various sports my whole lifetime. Hi Dr Creswell, Stories of Bicuspid Aortic Valve. He would be devastated to never be able to play again. His cardiologist said, i am sure he can play a full game with new issues but I have to go with new guidelines and indirectly left it up to me to make the decision which moved him to mild /moderate and put right at the Borderline. It has a male predominance and often occurs in multiple members of the same family, suggesting that it may have an autosomal dominant inheritance, perhaps with variable penetrance. 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. I cant imagine life without CrossFit, but I wont be able to continue will I? I dont believe there is any evidence that would help us know if some forms are safer than others. I have been given no restriction to date in any physical exercise as my valve is in decent condition. Thank you for this blog! You are correct that we worry about the influence of such activities on the enlarged aorta in those with BAV. I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. Bicuspid aortic valves are more common in men, but also affect women. O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. His last MRI showed a dilation of 4.4cm at his aorta root but his BAV is fine with very little leakage. I just want to know what things I will see change so that I dont look past the change in my valve and miss my window to get the valve replaced. 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. November Cover Star Gal Gadot Is in a League of Her Own A First Look at Diana and Margaret Thatcher in The Crown Season Four Celebs Roast Trump in Rhyme for John Lithgows Trumpty Dumpty Book Brace Yourself for George Clooneys Apocalyptic Movie The Midnight Sky The Best Shows and Movies Streaming This October Inside Netflixs Latest Binge-able Escape, Emily in Paris The Crowns Young Stars on Prince Charles and Princess Di From the Archive: How Hollywood Sharks, Mafia Kingpins, and Cinematic Geniuses Shaped The Godfather Not a subscriber? I am a marathoner with BAV and no other cardiac issues. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. I am considered elite in my age division. Historically, a heart murmur was the most common reason affected individuals were identified. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan. My daughter has played two years of varsity basketball already. No other issues. He posed next to statues of Thomas Jefferson, Jesse Owens (whose family moved to Cleveland when he was nine, and who later attended The Ohio State University), and Abraham Lincoln. PS I am really interested to know if HIIT is too intense a system of exercise for people with BAV. Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. BAV only has mild regurgitation. The important considerations in athletes with BAV are the degree of regurgitation of the valve and the degree of enlargement of the aorta. Anything you can offer up here would be very much appreciated. They seem very busy and its taken almost a year to get to this stage. 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 Heart Association to raise awareness. I have had scans and echos for as long as I can remember and have never been on medication nor has this condition stopped me from doing anything I have wanted. I was disappointed [when I was diagnosed]. Is operation needed? Copyright 2021-2022 Baldwin Publishing, Inc.All rights reserved. California Governor and movie star of films including The Terminator and The Predator, Arnold Schwarzenegger marked the 10-year anniversary of his heart surgery at USCs Health Science Campus. after surgery and was playing football again by September. The guidelines do not address the frequency of surveillance for individuals with BAV and no enlargement of the aorta. Do medications like beta-blockers limit any potential harm? At 4.0 cm, its important to be thoughtful about activities. March 10, 2016 at 1:50 pm. When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. Valve replacement with either a tissue (bioprosthetic) valve or a mechanical valve is, by far, more common. 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. His favorite sports are football and baseball. Really helpful. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. We just dont know. Thanks for the infoI really appreciate what you,have to say. I just thought it was muscle strain., My body cleared the blockage itself, said the game show host, who credited the aspirin he was taking for what he thought was simple muscle pain. Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. His exercise stress test on 8/5/16 was fine. I have a 15 year old son with a BAV, Aortic stenosis, Noderate regurgitation and dilatation of his ascending aorta. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. Open heart surgery is sometimes the best option, but it is not always the only option. After an MRI, Ive been diagnosed with BAV and mild aortic coarctation. An early indicator of BAV is a heart murmur, which is an abnormal sound caused by the turbulent . Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. "Know the symptoms ladies," she wrote. But thats just anecdote. Easy bicycling might work, but I suspect that running wont be workable with that cap. "The 1997 heart valve replacement was never meant to be permanent," stated Daniel Ketchell, a spokesman for Arnold. On Aug 30, 2017 I passed out at the gym and subsequently airlifted due a large abscess and valve dehisence and underwent another operation and now have a homograft. How long does it take for the homograft to completely heal? The doc says the big risk is due to the blood thinners. 2 Such features need to be considered before surgical intervention. Jeff. I am 6ft 3 . Thank you for best websit. 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. Yet Im personally aware of a good number of athletes whove returned to endurance sport after operations of various sorts for BAV,presumably after discussion with their doctors. This makes the aortic valve a tricuspid valve. 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. While the defective valve may be easy to see, the defect also causes changes in the tissues of the aorta and the heart. So it's got the Rock and Roll Hall of fame and great doctors. While I do expect to have a replacement done later in life, the repair was the best decision I could have made. My 28, got a BAV with mild stenosis and a aortic root measuring 40mm. Hi Dr. Creswell. 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. I would really like to know if I can (or shouldnt) push myself as hard as I used to. Normal biventricular size and function, no scar. Enlarged lv 37/58 mm rf 65 fs 36 Im wondering if you can advise me. Even if its one person I help. I took it up 7 years ago. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. And what would moderate weight lifting be defined as? There is a risk of sudden death in individuals with BAV, probably related most to aortic stenosis or aortic dissection/rupture. In January 2021, she underwent open heart surgery to install an aortic valve. I excercise 2-3 times a week, namely cardio and weight lifting. Bicuspid Aortic Valve: Symptoms, Diagnosis & Treatment, Biological Tissue Valves: Pig, Cow, Horse & Human, The Patient's Guide To Heart Valve Surgery. No LA, RA, RV, chamber dilation Others won't have symptoms until adulthood, if ever. I see in this blog that Dr. C noted: Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. 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. Im keeping my heart rate below 150, 160 at most but just for short period of time. Regards I see Im not alone. I suspect (and hope) you will say that the latest recommendations say no restrictions for someone like me but I havent seen yoga specifically mentioned. enlarged LV = 350ml The false lumen extending into the abdominal aorta was left since the point of origin in the ascending aorta was repaired. I see my cardiologist the end of May. There are several variations of this procedure that are applicable in specific situations. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. To continue to live this amazing life so full of challenges and friends, including so many of you in the audience, I have chosen to replace the valve with a new one. Its a hard thing to describe to my cardiologist that my legs and HR are not cooperating when the pace picks up. 140 miles at race pace. He has mild AS and AR and is otherwise asymptomatic.