Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. 24 HOUR GYM Aortic valve stenosis: Your aortic valve narrows, reducing blood flow through it. After that, most patients can gradually return to activities that put stress on the sternum and upper extremities. Search for heart hospitals that specialize in heart valve treatment. Functionally bicuspid aortic valve (type 1). During the Ross Procedure, the aortic valve is removed. I feel as though Im recovering well and, having no other conditions or comorbidities, rapidly. Replacement is much, much more common. Given my age and activity level, do you think it would be beneficial, or even prudent, to explore a valve repair surgery as you described above? Thank you sincerely for your time and information. I have regular checks, 12 to 18 months, and until about 3 years ago was told that it was hard to tell that Id had a replacement valve, it now shows slight stiffening. Hi Dr Creswell, My son is 16 years old and his story is very similar to many I read on your blog. O'Donnell suffered a heart attack in 2012, and wrote about her experience on her blog. There is very little scientific evidence to guide us here. To save nice heart the best would be doing nothing (! Glad to hear that youve found a surgeon and settled on a plan. I like to practice MTB and running competitively in local races. I dont want to do any damage or compromise my homograft as the last surgery was a very difficult recovery. Thank you,dr Creswell, Problem is, Im getting older (52) now and Im wondering the effect age, and should I be asking for more frequent followups. I take bisoprolol (low dose) and my pressure is currently normal . When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. Dr. Larry, very helpful content. 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. 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. Is this a possible explanation? I have also been advised that running intervals at over 80% max heart rate would not be sensible. Thats probably what the doctors are watching for. Good to hear that youre doing well. One situation that seems particularly ripe for differences of opinion is that of the athlete with BAV, no significant stenosis or regurgitation, but with an aortic diameter of 4.5 to 5.0 cm. The issues related to repeat aortic valve surgery, with or without replacement of the aorta, are complicated. 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. But neither of these procedures are durable for the long-term. My questions are For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? Im not sure theres enough information at hand to offer sound advice. I have a St. Judes Bovine valve now. Think to report back to let us know how things go for you, personally. Do you have any info or recommendations about this? Historically, a heart murmur was the most common reason affected individuals were identified. His cardiologist told him to focus on basketball. In general, we recommend no weight lifting in patients with BAV if the aortic diameter is greater than 4.0 cm. I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. Other heart parameters are very good (no bigger chamber or aorta). The studies on Irbesartan for Marfans(I dont have Marfans) are showing some positive outcomes; and. 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. I'm new to this group, so I'll be rather short. Schwarzenegger was born with a condition known as bicuspid aortic valve, in which the heart's main artery, the aorta, has only two cusps instead of three.If untreated, it can lead to blocked blood . The timing is my choice.. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. Ive yet to feel like Im back to my previous racing fitness that I once had. Thank you to every doc and nurse on my team.". Ive got my results from my recent echo and a lot of normals on there but main things were regurgitation and stenosis were mild with the aorta measuring about 33mm. Many endurance athletes are able to return to their sports after operation for BAV. Since you have the ready info about your aortic sizes over time, I will guess that you have a doctor or cardiologist that you are working with. 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. No enlargement of aorta or any other problems. For athletes with mechanical heart valves, the most important consideration is usually about potential bodily injury while taking blood thinning medications. Im 39 also diagnosed with BAV when I was 31. The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube. Or, is it something that can wait until they get sports physicals in their teens? Okay, thats greatbut I left feeling uncomfortable with the diagnosis. 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. Although bicuspid . If youre uncertain about any advice youve received about exercise, you might try to seek a second opinion that may provide some extra confidence about exercise. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. Hope to hear back soon. That would include weightlifting. I am mostly a runner, 4 times a week, with 10 21 km races. To make matters worse, I had a bout of AFIB, about 6 months ago. Hes gained 25 pds . Randyyour situation has many similarities to mine; I would be very interested in sharing experiences. My problem is a perpetual fear and worry about having this diagnosis and having to someday undergo open heart surgery. 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. It is two to three times more common in males than in females. This is such an interesting blog, I wish I had known of it sooner. They all cause a small bit of obstruction to blood flow as it leaves the heart. It is very informative. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports. 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 would really like for people to not have to experience what I had to experience, she continued. 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. I am 6ft 3 . Catch up on the years best movies, whether in theaters or now streaming at home. 5 months ago was diagnosed with severe AR and 5 cm long aneurism (root 3.0 cm, sinusi valsave 4.3cm, ST 3.6cm, ascending aorta 3.6cm) on regular yearly checkout, with no syptoms. I have been checked by echo/CT every year for the last 7 years to monitor the progress of my valve regergitation and aortic aneurism. Do you recommend any particular diet, exercise, vitamins,etc.? In both echocardiographic cohorts and surgical series, pure aortic regurgitation is significantly less common than stenosis. Rose underwent the procedure last week, and said he would be going home to rest for a couple of weeks before returning in March. This blog helped me a lot in my panic days, it put me at ease when I was worrying to much, just to see and to know your enemy and to realize that you are not alone is great help. This is thought to occur at a rate of about 0.1% per year in adults. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). Interestingly, bicuspid valves are one of the most common forms of heart valve disease. Theo Wargo/Getty. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? 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. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. 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. At the USC Cardiovascular Thoracic Institute, we are dedicated to improving the statistics concerning cardiovascular and thoracic disease such as those once faced by the governor, said Starnes, who also serves as executive director of the Institute. 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. Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 120/80-70. 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. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. Its always good that investigators are looking for new solutions to old problems. 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. You are a very good man. 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. Thank you for this blog! After an echo and an MRI with and without contrast, I found out that I have a BAV with mild aortic and pulmonic valve regurgitation. Youll need to rely on your doctors for advice about your condition. (I am on a low dose beta blocker) To list down the names of celebrities including entertainers, musicians, politicians, TV personalities, sports figures, etc. When I had my valve replaced I was told that it would have a 20 year ish life but I think it should exceed that. Last week I visited a doctor and here are the changes for the last year (before|after): He has been restricted from playing contact sports since hey was 10. Thank you so much for your clear explanations. Willie Moses host, 76, suffered a mild heart attack in 2012. 2) According to your explanation I rather not do cycling sports, but can I have low intensity sport like cycling or swimming twice a week for 90 minutes each, or 3 times for 60 minutes? What a great resource! 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. John Fox, NFL coach, suffered from Aortic Valve Disease. I have been doing as much research as possible on what are the advantages/disadvantages of each replacement. Aortic stenosis and bicuspid aortic valve (BAV) However, my surgeon told me that he could fit a tissue valve and so would not need to be on warfarin. This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . You might be wondering, with no disrespect to the great people of Cleveland, why Schwarzenegger, who surely has access to the finest hospitals under the sun, would choose to have surgery there. To much info to much detail so much information and advice. Bicuspid aortic value ppg 24 mmhg I just need to know if these sports are a possibility (im pretty sure football is a no given its contact nature). Sadly, no crystal ball is available. I feel like my HR takes longer to warm up and recovery after races is longer. 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. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). I was also advised that it is really the static weight-lifting that could pose a problem. Tyler. 140 miles at race pace. 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. No aneurysm. I have been given no restriction to date in any physical exercise as my valve is in decent condition. And lastly, the degree of healing in the remaining (unoperated) aorta probably has a big impact on the potential risk. Tetyana. 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. I think we should have a choice??? Susp. Since then I completed several 10k races and one half-marathon. Lastly, Id say that BAV alonewithout leakage or narrowing of the aortic valve, and without enlargement of the nearby aortawould not preclude sports activities of any sort. Just a short info for whomever may read, I searched for Tims name and I found this page: That said, the recommendations dont address WHEN that screening should occur. Yes, there are certainly patients with BAV who never need operation. Jones' goal with the AHA is to help women "actively put themselves on the track to heart health." His doctor recommended he see a pediatric cardiologist within 1-2 weeks but when I called they cant get him in until April 14th. I probably get more inquiries from athletes with bicuspid aortic valve (BAV) than any other single heart problem. These differences of opinion may be legitimate. Current guidelines suggest no restrictions on activity for athletes with BAV who have no stenosis/regurgitation and who have a normal sized aorta. We are trying to work out a way for her to continue to play. Now I wanted to start again (also due to the 8kg I accumulated in the meanwhile:( ) and I discovered that I can barely run 5K in 30 min and I generally find it very difficult to run. eventually was told everything was ok. During that first month we recommend ample walking as the best form of exercise. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. With aortic root 39mm. Probably a bicuspid aortic valve but there are many other possibilities Reply It has allowed me to do the thing I enjoy doing in life. I have bav with mild dilation of aorta 39mm. Get your act together, Columbus! Bicuspid aortic disease occurs when a defect is present in the valve that opens and shuts to allow blood flow from the heart through the aorta. Ive done the Philly a Marathon a coup,e times and know that its a terrific event. 7373 Perkins Rd My name became public 25 years ago this week. Glad to hear that youre recovering, Zdenko. I know I will need it replaced. I applaud your efforts to search out information to help you decide on a course of action.