Im hoping you can help with some guidance. You can see my post above, from 26th of april. They may also disrupt the normal flow of blood through the heart. To make matters worse, I had a bout of AFIB, about 6 months ago. Kimberly has experienced heart valve disease firsthand. Abstract. "I had to make lifestyle and diet changes, she said. While she ended up being okay, she advised other women to be more cautious. In practice, the indications for aortic valve replacement for severe aortic stenosis or severe aortic regurgitation are straightforward and uncontroversial. Im not sure how you should best sort out the differing recommendations from your doctors. It sort of flutters open and shut. Could he be over-cautious? Parenthetically, it may be time for an update. Hope to hear back soon. Normal function of cardiac valves And, of course, its important to monitor over time the function of the prosthetic aortic valve and the size of the aorta. They all cause a small bit of obstruction to blood flow as it leaves the heart. It seems to be a very interesting option for those who have aortic dilatation due to Marfan or BAV (which is my case). Bicuspid Aortic Valve with trivial AR. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. 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. Left ventricle (LV diastolic diameter 54mm|58mm, LV diastolic volume 142ml|167ml, LV systolic volume 39ml|57ml, Ejection fraction 72%|65%); Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. Enlargement of the left ventricle can be an indication that the heart suffers from the aortic regurgitation, even if the regurgitation doesnt produce symptoms like shortness of breath. I had multiple re-hospitalizations but seemed to recover. 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. Glad to hear that youve found a surgeon and settled on a plan. Dr. Larry, I do appreciate your insightful article very much. Also I seemed to get quite sweaty the following hours after a hard training session. To list down the names of celebrities including entertainers, musicians, politicians, TV personalities, sports figures, etc. Flaps of tissue on the valve open and close with each heartbeat. Aortic replacement. there was a tiny strand of tissue on the septal aspect of the muscular LOVT (LCOT Vmax 2.1m/sec;20mmHg peak gradient. Thank you for this blog! I love running. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. Im a 57 year old male who had aorta repair and porcine valve surgery 3 years ago. Sbp. I used to be very muscular prior surgery and 3 mounts ago I started with 5 km runs, push ups and pull ups 3 days a week, slowly progressing. I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. When first diagnosed with BAV I just nodded and smiled it was only the following day that reality hit home and I thought of all of the questions that I would have liked to have asked the cardiologist! However, I always performed poorly when it came to the top end fitness tests e.g. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. We were to see them in 3 months. Is it like keyhole surgery? If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. EKG and echocardiogram were done showing BAVD. Thats about as specific as he got. "Heart disease is the number one killer of all Americans, the number one killer of African-Americans and the number one killer of women, so I shouldve been put on notice since Im three-for-three. I can not be on anticoagulant medications on the fire department. However, randomized, controlled trials have excluded bicuspid aortic valve (BAV), which is the most frequent congenital heart disease occurring in 1% to 2% of the total population and representing at least 25% of patients 80 years of age or older referred for aortic valve replacement. After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets? This gives a chance for the sternum, which was split during the operation, to heal completely. BAVD is a malformation of the aortic valve present at birth that leaves you with two flaps instead of three, tripping up blood flow to the aorta. Nonetheless, I think theres considerable confusion about this condition, in terms of diagnosis, implications for the athlete, and its treatment. My consultant informed me that, because of my age, I would have a mechanical valve fitted which meant that I would be on warfarin for life and therefor not be able to play football. Star Jones. May 11, 2010 -- Barbara Walters said on Monday that her upcoming heart surgery, a procedure known as an aortic valve replacement, will hopefully correct a problem of which . Or its the result of the cumulative effect of the aortic and mitral valve 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. Also is it possible to never need surgery to replace the valve and that the AR stays stable, or even goes away ? There is recent interest and experience with aortic valve repairinstead of replacementfor patients with BAV. "I feel fantastic and have already been walking the streets of Cleveland enjoying your amazing statues. I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. Dr. Creswell, 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. 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 . This is thought to occur at a rate of about 0.1% per year in adults. These leaflets open and close to regulate blood flow from the heart into the aorta, and prevent blood from flowing back into the heart. Only restrictions are no weights greater than 100 pounds or heavy contact sports. The surgery was a full success, and the valve is closing really well now. I wouldnt put you in the position of giving me your opinion in a public in forum but just let me know if based on the following, you think Im crazy or not. He is on meds to slow it down. (Or do I just need to train even harder??). Last week I visited a doctor and here are the changes for the last year (before|after): Dear Dr. Creswell, Obviously, mild to moderate would be somewhere in between. PS I am really interested to know if HIIT is too intense a system of exercise for people with BAV. No LA, RA, RV, chamber dilation No information provided by Baldwin Publishing, Inc. in any article is a substitute for medical advice or treatment for any medical condition. I will update you all after his Friday appointment. Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. Like you mention, one theory is related to the aortic blood flow. 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. We have got two completely different opinions from our cardiologists: 1. The doctor allows me to do moderate sport defined by her like not 20k each day; 20k per week should be fine. The heart has a difficult time coping with extra demands of exercise. 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. My resting pulse is 55 and BP 115/82. 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. I have had three annual Echocardigrams, the first two showed mild stenosis, mild LV thickening. They can occur separately or together. Hi dr. 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 . The lines are the edges of the valve leaflets that open and close to let blood through. A bicuspid aortic valve (BAV) is an aortic valve that has only two leaflets instead of three. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. Have you heard about the PEARS procedure? Having a congenital heart defect means you are born with a problem with the heart's structure. Regards They dont know they have it [It] leaks blood. For example, are there data that shows what happens to aortic diameters once sports have been stopped? I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. Jeffrey Howell didn't know he was born with a bicuspid aortic valve until December 2015. In fact, in some people they can go undiagnosed for years. And slow enlargement of the aorta is common for patients with BAV. Although bicuspid . Sadly, we dont have a crystal ball, though to know what the future holds for any particular individual. Several famous people were reported to have had bicuspid valves: former first Lady Barbara Bush, the comedian Robin Williams, and California Governator Arnold Schwarzenegger. The use of a less invasive transcatheter therapy in this . Aortic stenosis and bicuspid aortic valve (BAV) Do medications like beta-blockers limit any potential harm? that suffer from heart valve disease along with a link to the reference story about heart valve disease and their Twitter handle to tweet on and promote the Valve Disease Day. Benefits: no blood thinning (with attendant risks) needed. You are correct that we worry about the influence of such activities on the enlarged aorta in those with BAV. He isnt interested in anything else. Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. Biscuspid Aortic Valve with trivial AR Also he told me I can lift weights and do other activities. Okay, thats greatbut I left feeling uncomfortable with the diagnosis. No aortic root dialation. Could I continue to train and just cut out the blood chokes? She is afraid, I can understand that. I think its reasonable to think of things this way. Now, five months after surgery Im gradually returning to sport with 5km runs and kettlebell routine, push ups and pull ups (still feeling pressure in breast bone) no heavy lifting. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. Moreover, there is a myriad of operations that such patients may have had, each with its on set of considerations. You have a good understanding of the issues. For some reason I did not receive a notification of your reply, so apologies that I havent thanked you before. And of course the problem occurs in everyday, recreational athletes, too. Thanks for my previous response a few weeks ago. Dear Doctor, Get on with it. The various artificial valves are a little bit less efficient that the valve were born with. Defects can involve the walls or valves of the heart, or they may affect the arteries and veins near the heart. The Best Amazon Presidents' Day Deals of 2023. There are many causes of light-headedness and chest discomfort that are not related to the heart. We have decided to wait and watch. All they said is dont really do weight where you can feel the strain in your neck ?!? The doc states that basketball is a contact sport in her medical books and we would need to consult with another doctor to possibly get approval. I am young with many years ahead, I dont want to accept this just yet when I know theyre is possibilty of repair. Advice in this area must be individualized with your doctor(s). The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. Interesting situation Sean Miller. Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. I do not have Julys echo results yet. I was training for 11th marathon at the time (over the past 13 years). Bicuspid aortic valve (BAV) and congenital aortic stenosis are two types of heart defects that may be present at birth. Soccer is his only sport and his passion- he plays on his high school team and a travel team. Yes, I am aware of the work by Dr. Dietz. Since then I completed several 10k races and one half-marathon. Consensus guidelines suggest that (athlete) patients with BAV and moderate enlargement of the ascending aorta should curtail their strenuous static (eg, weight-lifting) and endurance sporting activities because of the risk of aortic rupture or dissection. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. 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 think we should have a choice??? Your advice is always invaluable and most appreciated. "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. Replacement is much, much more common. Having a congenital heart defect means you are born with a problem with the hearts structure. I have not had any issues since my surgery. I cant imagine life without activity, but Im not fool to risk my life, not any more anyway :). Im 53. On said it wont make a real difference, the other said oh yes, that was like a blockage, you will feel the difference. My primary question relates to sports. Maybe you can help me with some questions. I had a cardio version to correct the AFIB. In April of this year (2016), I discovered I had a BAV in the worst manner possible. Questions about Bicuspid Aortic Valve!! We just saw them in January. Look forward to your reply and thanks for your time. Instead, even with continued sports participation, the progression of both valvular and aortic disease is no different from that in the general population. However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. 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. They are also predisposed to enlargement of the ascending aorta, the large blood vessel that carries blood flow away from the heart. The worse the narrowing, the greater will be the difference in blood pressure between the arms and the legs. Many endurance athletes are able to return to their sports after operation for BAV. Im 39 also diagnosed with BAV when I was 31. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. 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. Historically, a heart murmur was the most common reason affected individuals were identified. Im obviously quite anxious that Ill drop death! The cardiologist told us at that appointment that we needed to start considering surgery to repair his valve. Thanks for the infoI really appreciate what you,have to say. This valve repair option is one that might best be pursued at a center that specializes in this problem. I have also had a stress test, which showed no issues at all. To me, you know your own body and what you can manage whilst straining as little as possible. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. 1. I recently also did a 24hr EKG (holter) which was fine. Last week, the CBS This Morning anchor announced via his co-anchors Gayle King and Norah ODonnell that he would be taking a break from the show to undergo heart surgery. Normal LV diastolic function. Is a CT or MRI absolutely necessary for measuring the aortic diameter? 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. My son is desperate to be able to play sports without any restrictions. I look forward to hearing from you. The valve can gradually become harder to open or leakier . Would this have any affect on any of the results of the tests I have done (Echo, EKG, Chest Xray)? A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle.