Thank you very much for your thoughtful response. Based on the information Ive provided, I would greatly appreciate your advice and opinion on the matter. Hello dear doctor. I have only trivial aortic regurgitation. Dear Dr Creswell you seem to be such a kind cardiac surgeon to make yourself available in answering questions. My daughter has played two years of varsity basketball already. I am a 60 yo female who has been active my whole life. I was wondering if you could give your opinion on my scenario. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . Barb. Want to get a head start on your Oscar predictions? 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. He left it pretty vague. That said, guidelines from the 36th Bethesda Conference suggest that BAV, without enlargement of the nearby aorta or problems with the aortic valve, shouldnt preclude any sports activities.including weight lifting. I am now 60. Soccer is his only sport and his passion- he plays on his high school team and a travel team. Related posts: ps. Currently complete in 5-a-side football and have done for life. I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. Follow up for development of these functional lesions is indicated. Heart disease and stroke are the number one killers of women, Streisand, 74, told PEOPLE about why she helped found the organization. Jeffrey Howell didn't know he was born with a bicuspid aortic valve until December 2015. no symptoms yet please help. 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). They may also disrupt the normal flow of blood through the heart. And I took him for check up every year and nothing change and he never had any symptoms. It doesnt help that I am a nurse. I will update you all after his Friday appointment. I would defer to Dr. Dietz since youve already contacted him. However, my most recent scan in October revealed all Stenosis and LV thickening had gone completely (Doctor said this was a very positive result perhaps due to excercise and medication). And slow enlargement of the aorta is common for patients with BAV. Would this have any affect on any of the results of the tests I have done (Echo, EKG, Chest Xray)? Cardiac outcomes in a contemporary population of adults with bicuspid aortic valve have not been systematically determined.Objective To determine the frequency and predictors of cardiac outcomes in a. Most patients (like me), however, start to experience problems during their 30s, 40s, and 50s. I had a cardio version to correct the AFIB. With aortic dissection, the aorta can develop a tear on its inside wall, leading to unraveling of its layers, and even rupture. My aortic root is 4.06 cms. Only your cardiologist and heart surgeon will be in a position to make those considerations. We are now seeing moderate stenosis, hence replacement in the not too far distant future. Have been told to keep away from exercises that strain me, ie heavy weights. after surgery and was playing football again by September. Do you recommend any particular diet, exercise, vitamins,etc.? This is an area where second opinions may be helpful in sorting out whats safe. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. Do medications like beta-blockers limit any potential harm? Bicuspid aortic valve. I feel like my HR takes longer to warm up and recovery after races is longer. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). In late March, Schwarzenegger was heavily involved in a chess tournament with his donkey Lulu. The Institute is a unique collaboration of cardiothoracic and vascular surgeons, cardiologists, pulmonologists and basic scientists all working together without the boundaries of departments or specialties. I realise that I will eventually need the valve replaced again and just hope that things go as well next time. What does heavy weights mean? 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. Very helpful. The HAART 200 is an innovative device that helps in the repair of BAV, allowing patients to avoid aortic valve replacement. Ive been told by my cardiologist that they think I should probably avoid competitive rowing and weight lifting. I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. With the blood thinning needed for a mechanical valve, serious bleeding may occur with injuries. My heart seems to heal, so that speaks well for my future.. Best for athletes like you to have a discussion with their doctor(s) and settle on a defined, mutually acceptable course of action about which sports activities are safe. My problem is a perpetual fear and worry about having this diagnosis and having to someday undergo open heart surgery. Are we being foolish? For healthy individuals who have BAV with no other heart or aortic problems, follow-up imaging with echocardiogram and/or CT could probably be undertaken annually, or perhaps less often once stability is ensured. The CVTI was created under the leadership of Dr. Vaughn Starnes, chair of the Department of Cardiothoracic Surgery and surgeon-in-chief at the Keck Medicine of USC. First, Id encourage you to follow your doctors advice. Aortic valve repair and aortic valve replacement are done to treat aortic valve disease. My surgeon says that the aneurism and bav go together. Congrats! Dr. Creswell I had surgery when I was 10 years old to replace my bav with a St.jude mechanical valve. In your experience how long are we talking before I have to have surgery and do beta blockers really help in prolonging the need for surgery. 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. Yes, I am aware of the work by Dr. Dietz. Im 33 from UK and have known about my BAV since I was around 18. 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. I currently lift reasonably heavy weights in the 8-12 rep range, including body weight excercises such as pull ups and push ups. 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. Did you run? I am concerned about removing the coronary arteries and re attaching them again etc. I do not know aorta measurements. Do you have any info or recommendations about this? Best to continue to work towards identifying cause(s) and getting any needed treatment. I ran a 1/2 marathon 4 months after my surgery and have been since training for the Philly FULL marathon, which is tomorrow. Aorta diameter (34 mm|34 mm); Thank you to every doc and nurse on my team.". It seems to be a very interesting option for those who have aortic dilatation due to Marfan or BAV (which is my case). Seems unlikely to me that there would be lingering effects that would make an EKG or chest x-ray abnormal. In the process of how I had the slow waltz with MG UNTIL DIAGnosed, will be ready in 3 weeks. The typical symptoms are fatigue or shortness of breath, particularly with exertion. However, is there any advantage to having them screen in their first decade of life, if they are not showing any symptoms? I know it can be frustrating when you get conflicting opinions regarding the safety of exercise. Celebrities With Heart Disease - Celebrity Heart Health Survivors. Im keeping my heart rate below 150, 160 at most but just for short period of time. Ive starting going to the gym again and doing cardio with weights to tone up. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. O'Donnell suffered a heart attack in 2012, and wrote about her experience on her blog. 2 Such features need to be considered before surgical intervention. Do you think the weights Im doing at the moment seem OK with those results ? 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). This was during a 12 week intense training block where my resting heart rate got as low as 42 bpm. Latifah has taken on her mom's caregiving duties, along with relatives and a nurse, whenever she is on the east coast. It may cope adequately for a few years if the person leads a sedentary life, but the longer crucial surgery is delayed, the more damage there will be to . But I recognize that not all cardiologists or heart surgeons would agree. As I train triathlon I check my heart every year and there is small back flow (the same last 5 years). Is that so, or can it be measured by the echocardiogram as well? Who Qualifies for TAVR. Advertisement. Throughout the years he has played football and basketball. Perhaps your primary care doctor or cardiologist could help you find another specialist in your area who could help with thatlook over all of the pertinent information and share an opinion about whats safe. In my practice, we often do such second opinions (about all sorts of issues) and I have found that athlete patients usually value the information that comes from such visits. I ran competively for a division 1 NCAA university through college and have maintained a high level of physical fitness since. We see his pediatric cardiologist every 6 months. ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. Bicuspid aortic valve: A bicuspid aortic valve only has two leaflets, increasing the risk of circulatory problems and heart conditions. Many thanks again for answering this. Pop Medicine > Celebrity Diagnosis . Oh, plenty. These Famous People Survived Congenital Heart IssuesYou Can, Too, On-Site CLIA Certified Laboratory Services, Click here for COVID-19 & Vaccine Information, Actor, body builder and former California Governor, After winning three Super Bowls with the New England Patriots, linebacker. My doctor says i use losartan for decrease my blood presure. The pitfall, though, is that our native aortic valve is itself very efficient. (Yes, I have been going for regular check-up since in was about 7 years old. The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube. However, this is not always the case. Crossref Medline Google Scholar. Thanks for sharing your sons story. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. My cardiologist has advised me to avoid high impact activities such as weight lifting and endurance training. What a great resource! Should I be doing push-ups/pull-ups? However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Replacement of the aortic valve with either a cryopreserved human homograft (the aortic valve from a human cadaver) or with the patients own pulmonary valve results in the least obstruction to blood flow. I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. I would think that, ordinarily, a homograft would heal up along a similar timeline to other types of valve/aortic root replacement. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. This site complies with the HONcode standard for trustworthy health information. I am a keen weightlifter, which is the basis of this post. Im a 42 year old male and have been a highly competitive distance runner since high school. The aortic root is moderately dilated (max 46mm sinus to opposite commissure but you can measure 48off axis). I have also had a stress test, which showed no issues at all. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. Its probably not possible to have too much information as you think about your situation. Get your act together, Columbus! The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). The issue of how much (& what types of) exercise after surgery is difficult because we dont have good studies (& evidence) upon which to base recommendations. It is very frustrating as my doctor would prefer to see me live the rest of my life with restrctions and have the aneurysm stabilized rather than take a chance on surgery and possibly returning to my normal lifestyle. And now my aortic root is 42 mm. Not sure I have something specific to suggest for additional reading.and I dont know where to steer you about a knowledgeable trainer in the UK. Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. I have question about your opinion about aortic valve regurgitation (no BAV) Make no mistake, though. So far, none of the people that had the operation suffered any dissection. (Have you heard of the studies by Dr. Is this true that you wont be symptomatic with only mild AR? I cant imagine life without activity, but Im not fool to risk my life, not any more anyway :). There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). But Bob, you confirm that it does for you; and unfortunately I see same for me although 25 years younger. I would pose these questions to your doctor(s) since they are most familiar with the details of your situation. Dietz?) Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. Unanswered questions include: Can a bioprosthetic valve wear out more quickly than expected? His last MRI showed a dilation of 4.4cm at his aorta root but his BAV is fine with very little leakage. When we go back to re-replace a patients prosthetic valve, for some reason, it usually has to be chiseled out from the heart. I have been advised not to run any more marathons or half-marathons, but that I can still compete at up to 10km races. We have made the decision to stop playing high school soccer and will reevaluate in 6 months to determine about Spring team soccer (less intense). By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Ive yet to feel like Im back to my previous racing fitness that I once had. 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. An abnormal aortic valve develops during the early weeks of pregnancy, when the baby's heart is developing. Thanks a lot for your answers. Frequency of congenitally bicuspid aortic valves in patients 80 years of age undergoing aortic valve replacement for aortic stenosis (with or without aortic regurgitation) and implications for transcatheter aortic valve implantation.Am J Cardiol. Also hypertension in both arms. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. Aortic Stenosis I continued playing hockey routinely until I was in my late twenties. When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? Sbp. 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. For athletes with mechanical heart valves, the most important consideration is usually about potential bodily injury while taking blood thinning medications. In your case, though, the infection might well influence the healing process. ), What do you think? 2) He can lead a normal life & can continue his training with regular echocardiography control (once in a year). Last few weeks Im getting chest pain on left side (very rarely on right side) while running and doing push ups. Without careful study, I dont know what the true risks will be. 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. Finally some solid information about exercise and life post AVR, thank you very much for that. 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. Glad Ive found this website! Have you heard about the PEARS procedure? As I mentioned in previous comment my recovery is going great. Biscuspid Aortic Valve with trivial AR On March 30, 2018, we learned that Arnold Schwarzengger required a second heart surgery. In addition to the European guidelines, there is also an American set of guidelines published in the Proceedings of the 36th Bethesda Conference. Hi dr. My questions are: Surgeon Q&A: What is TAVR Valve-in-Valve? triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? I asked my surgeon and also the echocardiographist about my sports performance after full recovery, about 6 months after the surgery. So I saw an incredible surgeon and we are going for the Ross Procedure in Feb. Now that we know the type of surgery does this improve my chances or one day returning the CrossFit addicted life I miss? The aortic valve allows oxygen-rich blood to flow from the heart to the aorta. If you wont we can share experiences about healing and progress, its pretty much same situation. The Best Amazon Presidents' Day Deals of 2023. Could you please give me an insight into what else could be causing these chronic episodes of shortness of breathe, lightheadedness and off-on chest pains. thanks for sharing all this interesting info. The idea of somehow restricting the HR may be attractive as a means of curtailing strenuous activity. 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. 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The data regarding the progression of disease in athlete patients with BAVare limited. I took it up 7 years ago. 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 . Elite triathletes and heart problems But if you have a bicuspid aortic valve, you only have two cusps. Now at 74, and after having AVR I am 10 weeks into the dont lift more than 10 pounds restriction. Im hoping you can help with some guidance. There are several variations of this procedure that are applicable in specific situations. Ive a BAV with the fusion being between my right coronary and non-coronary leaflets. Can BAV cause sudden death incidents in otherwise healthy 40 year old males? 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. is my lack of top end performance indicative of someone with BAV & aortic coarctation? He was just diagnosed with functional BAV due to partial stuck together of two leaflets (out of three, as far as I understand, they are equal). There can be issues with aches and pains even months after operation that still relate to healing. swimming? Parenthetically, it may be time for an update. Your site has been helpful in provided a sense of peacebut an extra insight would be super encouraging. Is it like keyhole surgery? The issues of when, how, what sports are safe, etc. Mild degrees of aortic regurgitation are usually well-tolerated and do not produce symptoms. He told me to carry on as normal and to take 300mg Irbesartan per day. Just a short info for whomever may read, I searched for Tims name and I found this page: Could you express your opinion on this issue? Thoughts. The guidelines were developed by an expert panel based on the scientific information available at that time: The issue has not been studied very well, but one recent study suggests that continued participation in sports for periods of up to 5 years does not change the natural history and progression of BAV. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. Specifically, Im wondering about inversions like forearm stand, head stand, and hand stand. Film star, former California governor, and seven time winner of the Mr. Olympia title Arnold Schwarzenegger published positive images to his social media platforms on Friday as he recovered from heart surgery. My primary question relates to sports. "Schwarzenegger's pulmonic valve was successfully replaced.". 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? Thank you for your time Dr.! Is this the case? Me, i`m nearly 43, male and have BAV. 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. In large-scale pre-participation cardiac screening programs for young, competitive athletes, BAV is one of the most commonly identified abnormalities. Im not sure how those two problems would be related. 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. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. All rights reserved. James Cameron checks in from Pandora with a status report. No LA, RA, RV, chamber dilation Something they suspect is also from birth but never previously picked up. But for those WITH such problems, we do recommend curtailing either static or dynamic activities, or both. We saw cardio in April again and my sons symptoms are the same and no progression on the aortic regurgitation. "Know the symptoms ladies," she wrote. Hes a 30-year-old 8th grade science teacher, a cyclist and outdoorsman, who is chronicling his story with BAVfrom diagnosis, to evaluation, to preparations for upcoming valve replacement surgery. 140 miles at race pace. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). Rhm, 43, tragically lost two of her family members to heart issues. Hi Dr. Creswell. no tiredness, no dizziness, etc. No thrombus, vegetation were noted I had a Type A aortic dissection of the ascending aorta that extended into the descending aorta terminating near the femoral arteries. Diagnosed last year while looking at something else. I was born with a BAV and but I didnt notice performance issues until the Summer of 2016, so I brought myself to the doctor. 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. The thing that keeps me sane is that I can jump on a treadmill or go play basketball for a few hours and feel relatively normal. My son will seek a repair when his conditions deteriorate. Or, is it something that can wait until they get sports physicals in their teens? Yes, there are many athlete patients whove had operation for BAV/aortic replacement and returned to a variety of sports. Most patients spend about a week in the hospital after operation and then are able to go home. You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. Then, Arnold's pulmonary valve was switched to the aortic position. Aortic valve regurgitation: Blood leaks back into your left ventricle instead of only flowing into your aorta. however I have been getting pain (on the left side of my breast) and chest pain due to lack of oxygen. It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes. No stenosis, no calcification. Those figures are funny to me because before I was doing three or four times more intense training beside my job (air force pilot). You should discuss this possibility with your doctor(s). I would really like for people to not have to experience what I had to experience, she continued. No LV chamber chamber dialiation, normal LV wall thickness, good LC systolic function, No regional LV wall motion abnormality. Keyhole just refers to the type of incision used for conventional valve replacement like you had. Ed Helms - Actor - Undisclosed CHD. Thanks for sharing an update. I played competitive amateur football (soccer) on Saturday and Sunday from age 16. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports.
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