That said I have a resting HR of ~40 (always have). Lynn. I am 31 years old and had my BAV repaired at The Cleveland Clinic in 1999 when I was 15. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). And judgment would be needed. I am healthy, strong, and active. Tyler. This was during a 12 week intense training block where my resting heart rate got as low as 42 bpm. These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. I have a few questions because I was instructed not to lift more than 10 lbs and that I could resume surfing in a year. My personal approach to endurance athletes in this situation would be to offer operation if the patient wanted to continue to participate in endurance sports (after operation) and was willing to assume the risks of operation. She advised us we should start to consider surgery but would follow up with us again in 3 months. Ive heard from a fair number of endurance athletes after having aortic valve operations of one sort or another. I know that heart surgery can be scary.but I also know that for the vast majority of patients with these conditions, surgery goes well and the outcomes are good. My son is 16 years old and his story is very similar to many I read on your blog. I would think that, ordinarily, a homograft would heal up along a similar timeline to other types of valve/aortic root replacement. ), Your email address will not be published. I would defer to Dr. Dietz since youve already contacted him. Medical therapy may be useful to slow or halt the progression of aortic valve disease and aortic enlargement by reducing the blood pressure and the blood pressure across the aortic valve. Im paranoid to exercise too much for fear that I will do damage to the valve. If you suspect you have a heart issue, either because you have symptoms or a family history of heart problems, see a doctor. I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. "I had to make lifestyle and diet changes, she said. There are 2 broad categories of heart valve substitutes that can be used to replace the human aortic valve: mechanical valves or bioprosthetic (tissue) valves. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. I cant think like a nurse where hey is concerned. I found a cardiologist with whom Im quite happy with. Im 33 from UK and have known about my BAV since I was around 18. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. Yoga is not included in the classification of sports that is commonly used, but I suspect that yoga would have low to moderate static and dynamic components. I would not want yo distinguish between the various forms of static exercise that you mention. Follow up for development of these functional lesions is indicated. I think its reasonable to think of things this way. 1. Less than one month ago Schwarzenegger was (virtually) hosting the Austrian World Summit of the Schwarzenegger Climate Initiative, which introduced speakers like Prince Charles, Jane Goodall, and Pakistani Prime Minister Imran Khan. I played competitive amateur football (soccer) on Saturday and Sunday from age 16. If a large enough valve is implanted, there may be no noticeable impact on the ability of the heart to do extra work that comes with running (or any exercise). Data from these studies supported the U.S. Food and Drug Administration's approval of TAVR for low-risk individuals - replacing a narrowed aortic valve through a small incision in a procedure . In large-scale pre-participation cardiac screening programs for young, competitive athletes, BAV is one of the most commonly identified abnormalities. How long does it take for the homograft to completely heal? Here is a link to a diagram that categorizes sports according to their dynamic and static components: http://www.athletesheart.org/wp-content/uploads/2013/12/Classification-of-Sports-300217.png. In fact, one young man died 5 years after operation (from other non related causes) and the study on his aorta tissue revealed that the device helped it to heal, presenting a healthy histology. I ran a 1/2 marathon 4 months after my surgery and have been since training for the Philly FULL marathon, which is tomorrow. I would prefer not to stop. Hey has been physically active with restrictions of no contact sports, and no isometric exercise. Hamilton mother of twins, Cherie was diagnosed with bicuspid aortic valve disease (BAVD), a disease where the valve has only two leaflets. Many of us are not familiar with the many types and facets of the martial arts. The Best Amazon Presidents' Day Deals of 2023. I was diagnosed age 4 and am now 35. It is unclear however if there are cardio thoracic surgeons who perform minimally evasive repairs yet. You have a good understanding of the issues. Doing nothing wont be great for my heart and wont extend my life neither probably.. After the scans, ultrasounds, stress tests and TOE, I was diagnosed with BAV with no Stenosis, no Aortopathy and no evidence of Coarct and normal LV size and function. Males are affected 3:1 compared to females. 2 Such features need to be considered before surgical intervention. Aortic stenosis, the narrowing of the aortic valve. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. Barb. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. Males are about twice as . However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Beta blockers are frequently prescribed in the circumstance you describe, but in truth we dont know if they will be effective in delaying surgery for any given patient. No other issues. Yes, there are many athlete patients whove had operation for BAV/aortic replacement and returned to a variety of sports. My son will seek a repair when his conditions deteriorate. Call 911. Sory but I dont speak very vell english. Bicuspid valves are quite common (1-2 percent of the population). What is your opinion about dissection in low/controlled messures? My cardiologist has advised me to avoid high impact activities such as weight lifting and endurance training. What have I observed and learned in the quarter century since? Very often, follow-up CT scans and echocardiograms are needed every 6-12 months to keep track. (Or do I just need to train even harder??). Hi Dr. Creswell. What is a TAVR? 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. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). Great article! The only question I have is in regards to having my children screened. Or is the real risk related to further deterioration of the heart in the longer term that would be picked up by 6 monthly monitoring, which may indicate the need for surgery but not an immediate risk of dying suddenly? They said that everything is working fine except that I have a slightly enlarged aorta and the very beginnings of an aortic aneurism which most likely occurred PRIOR to surgery as a result of the pressure over the years and my old BAV. 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. Is there any research on this? Unanswered questions include: Can a bioprosthetic valve wear out more quickly than expected? document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. Yes, there are certainly individuals with BAV who go a lifetime without needing valve replacement or aortic surgery. Holding breath during lifts valsalva). Dear Dr. Creswell, Moderately dilated aortic root (max 46mm), mild ascending aortic dilatation. when I discussed this with my Dr. he reassured me that its not my heart causing it. The other theory is that there is a structural problem that leaves the aortic wall weak. There is a risk of sudden death in individuals with BAV, probably related most to aortic stenosis or aortic dissection/rupture. This content can also be viewed on the site it originates from. I am big for my age . 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. 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. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. They included a web link to the European medical guidelines. My heart seems to heal, so that speaks well for my future.. Athletes with BAV and enlargement of the aorta to greater than 4.5 cm can participate safely only in low intensity sports (eg, golf, bowling, billiards). Your sons cardiologist would seem to be in the best position to offer specific advice. Regards Will I need surgery? Thank you for this blog! Without careful study, I dont know what the true risks will be. Elite triathletes and heart problems A 2nd opinion might help by bringing another set of eyes and ears to your problem. That said, the recommendations dont address WHEN that screening should occur. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan. I hadnt heard about the technique previously. 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). He loves sports and is wanting to do more and more. These operations can sometimes enjoy the benefits of each of the operations you mentioned.and avoid done of the down sides. Related posts: Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. Thank you very much for your thoughtful response. The surgeon I used told me that he had performed keyhole surgery once but wasnt sure if it would be of much benefit to me. my age is 20 right now I found myself in emergency surgery 12 months ago with 50% leakage, an enlarged heart and an ejection fraction of 30. Before 2 years my aorta was 37mm . In addition to the European guidelines, there is also an American set of guidelines published in the Proceedings of the 36th Bethesda Conference. The Cardiologist now suggesting taking beta blockers as a way to slow things down and has advised that anywhere from 4.5 to 5.0 is where he would consider intervening. However, some people are born with an aortic valve with only two leaflets, known as a bicuspid aortic valve. Ive seen several cardiologist and they are divided in recommendations. New guidelines from 2015 are in accord with your doctors recommendations about vigorous exercise as well as periodic imaging to measure the aorta. 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. Activities are not usually restricted for athlete patients with mild aortic stenosis. Regarding activity restrictions, you would do best to rely on the advice of your sons doctor(s) who will be in the best position to know the relevant specifics. To me, cardiologists are not sports people and air on being absolutely over cautious. We use surveillance (you mention every 6 months) because usually problems with progressive enlargement of the aorta or with the valve itself can be picked up before there is any lasting harm. Looking forward to hearing your thoughts. Congrats! 7373 Perkins Rd Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. Again, thank you and bless you for taking the time to talk with us here! Just double checking. The potential downside relates to durability. Normal great vessel size Thats always the concern with new techniques with limited follow-up data. You already have a cardiologist looking after you. But like a lot of women, I thought that heart disease was an old white guys disease," the former talk show, 56, host tells PEOPLE. Vanity Fair may earn a portion of sales from products that are purchased through our site as part of our Affiliate Partnerships with retailers. It would be great to know what happens to groups of patients after AVR and aortic replacement that have returned to their various sports. My son is devastated, depressed, and wanted to play ball in college. 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. Max Page - Child Actor (Darth Vader in VW Superbowl ad) - Tetralogy of Fallot. "Thanks to the team at the Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery," he wrote. My cardiologist (London Heart Hospital) gave me green light to moderate sport activities (no marathon and weight lifting). There are many surgical options depending upon the particular circumstances. Now I take brisk walks and run on the treadmill only occasionally. i.e. This makes the aortic valve a tricuspid valve. I have recently found out that I have aortic regurgitation will soon be needing surgery. Zdenko . . Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. Obviously, I underwent emergency surgery to replace the aortic valve (Medtronic open pivot mechanical valve) and have the aneurysm repaired with a dacron graft. My aorta diameter is 4.0 cm and has increased by 0.8 cm (from 3.2 cm) in the past 5 years so the diameter is increasing rapidly. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). There are a lot of variables here, even from the short story youve shared. Barb. Several famous people were reported to have had bicuspid valves: former first Lady Barbara Bush, the comedian Robin Williams, and California Governator Arnold Schwarzenegger. Thank you for answering these questions. You should discuss this possibility with your doctor(s). I had AVR 3 years and 4 months ago. The abnormal anatomy of the bicuspid aortic valve is complex, and a classification schema of 3 anatomical types has been proposed by Sievers and Schmidtke. My aortic root is 4.06 cms. They all cause a small bit of obstruction to blood flow as it leaves the heart. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. The free weights are about 10kg and Im not doing any really heavy weights. Questions currently remain about how long such repairs will last and whether patients might require re-operation at some point in the future. You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. The pertinent questions for your cardiologist is whether there is any stenosis (narrowing) or regurgitation (leakage) of the aortic valve and whether the size (diameter) of the nearby aorta is normal. They can occur separately or together. If the valve is smaller than needed, there can be a limit to the ability of the heart to do extra workand that can show up as less speed. There are many causes of light-headedness and chest discomfort that are not related to the heart. Hello Dr. Creswell, Only restrictions are no weights greater than 100 pounds or heavy contact sports. Seems unlikely to me that there would be lingering effects that would make an EKG or chest x-ray abnormal. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. I am playing basketball I am doing 100m and 200m and swimming . For example, are there data that shows what happens to aortic diameters once sports have been stopped? Thank you for taking the time to respond to my post. In addition, the Left ventrical has slowly increased over this same time period from 5.87 to 6.6 cm. Good to hear that youre doing well. http://www.energystretch.com I can tell my story. I had a David Tirone Operation a couple of weeks ago to repair a BAV with aortic dilatation (49mm), and a small leakage. Dr. Larry, I do appreciate your insightful article very much. I have only trivial aortic regurgitation. In March 2019, media outlets hailed two new studies on transcatheter aortic valve replacement (TAVR) as potentially signaling the beginning of the end of open heart surgery for aortic stenosis. I have some issues with a dull pain right below my left breast that seems to come more often with a poor dietbut just doesnt seem like it could me esophagus related? In April of this year (2016), I discovered I had a BAV in the worst manner possible. The aortic valve lies between the heart and the aorta, the main artery . Sometimes it comes even when not exercising. The procedure was performed at the Cleveland Clinic. "Know the symptoms ladies," she wrote. He was very talented at football. 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 . What activities can I do? lessons) Search Heart Hospitals This has caused me a great deal of anxiety because I feel like I am being told to act like an old man before my time. Dr Creswell, So unfortunately it sounds like i am part of that grey area. Approximately 1%-2% of the population are born with an aortic valve that only has two cusps. Perhaps the best course of action might be to start off very conservative with exercise, as you are doing, with periodic assessment of the aortic valve and aorta with echo and CT. You might then gradually increase the activity and monitor for any bad signs with the periodic echos and CTs. 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 . SPORTS FIGURES/ATHLETES. He is on meds to slow it down. 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 currently lift reasonably heavy weights in the 8-12 rep range, including body weight excercises such as pull ups and push ups. The various artificial valves are a little bit less efficient that the valve were born with. As I restart my resistance (weight training) program what should be my upper limit weights? For some reason I did not receive a notification of your reply, so apologies that I havent thanked you before.
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