Great to hear that youre doing cross country running. 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 . My Dr is almost certain that these symptoms are caused by issues that are not cardiac related, and that with at the stage my BAVD is at, it would not produce symptoms. Always best to heed the advice of your doctor(s) who will be in the best position to offer advice about safe forms of exercise. Im am in stres ?! 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. In your experience, can patients with BAV go a lifetime without having AVR? with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). Did the heart have to work harder to compensate? Perhaps a cardiac surgeon would be able to provide even more detailed information about things like various options for operation that might be applicable in your case as well as thoughts about when operation should be performed. Perhaps other readers will comment. I excercise 2-3 times a week, namely cardio and weight lifting. Over time, these patients need to be monitored for continued proper function of both the pulmonary valve (that was borrowed) and the new substitute for the pulmonary valve. In this case, would it be an overwhelming pain? In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. Dr. Creswell, Im afraid Ill end up like my Mom. Thank you sincerely for your time and information. So far, none of the people that had the operation suffered any dissection. Typically, the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two cusps (bicuspid aortic valve). However my Sinus of valsalva is dilated between 45-47mm (depending on the machine used). Aortic valve repair and aortic valve replacement are done to treat aortic valve disease. I will update you all after his Friday appointment. Im not familiar with employment eligibility issues with BAV, even in this country. 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 Marfanss syndrome. host, 76, suffered a mild heart attack in 2012. 27yr old male. It is very informative. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. Surgeon Q&A: What is TAVR Valve-in-Valve? The average lifespan for a cow valve or pig valve is about 10 to 15 years, according to the Cleveland Clinic. Sory but I dont speak very vell english. Hey is almost looking forward to getting it fixed. Women are 50 percent more likely to be given a wrong diagnosis after a heart attack and are at a greater risk of dying within a year of a heart attack than men. Now Id like to know your opinion about physical performance, before and after. Good to hear that youre making a good recovery from your second operation. Is this a possible explanation? To me, cardiologists are not sports people and air on being absolutely over cautious. swimming? I will do whatever I can to make sure my mom is comfortable and has whatever she needs, she said. Normal pericardium, no pericardia effusion Join Vanity Fair to receive full access to VF.com and the complete online archive now. Also he told me I can lift weights and do other activities. There were some procedural differences between the bicuspid and tricuspid groups. Thats the main reason for choosing a tissue valve in my case. ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. And of course the problem occurs in everyday, recreational athletes, too. In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. 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. If the valve does not close completely, blood can leak into the heart. 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. eventually was told everything was ok. 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. I have wife and two small boys, I wanna live to see my grandchildren. Bicuspid aortic value ppg 24 mmhg The star's mother, Rita Owens, was diagnosed with heart failure after passing out while teaching art at a New Jersey high school in 2004. I seen my cardiologist yesterday and this is the first year in 4 years that the aneurysm hasnt grown a mm. Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. On April 16, 1997, Arnold Schwarzenegger underwent elective heart surgery to replace a defective, congenital aortic heart valve. Now at 33 years of age the valve is 23 years old and has served me very well. Throughout the years he has played football and basketball. I dont know about the relative effectiveness of various ARBs used for this purpose. Want to get a head start on your Oscar predictions? Running it is important for me but if it has a problematic effect , I would opt for power walking Its probably not possible to have too much information as you think about your situation. Is that far fetched? Most patients (like me), however, start to experience problems during their 30s, 40s, and 50s. Dr. Larry, I do appreciate your insightful article very much. Many congenital heart defects cause few or no symptoms. Adam has been featured by the American Heart Association and Medical News Today. 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). My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. Some cardiologists tell me that I can run up to 130 beats per minute ; others say theyd prefer I do power walking because pressure always rises while running. Dietz?) PS I am really interested to know if HIIT is too intense a system of exercise for people with BAV. Keep us posted! 24 HOUR GYM Thank you for answering these questions. He told me to carry on as normal and to take 300mg Irbesartan per day. What Is Bicuspid Aortic Valve Disease? Hi . I am 51 and leaning towards a tissue valve because of my activities and that I am a firefighter. His story is typical. Any person in my family there was no problem with the heart. Celebrities with congenital heart disease Details Published: January 27 2016 . 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. A bicuspid aortic valve only has two of these leaflets. 2. Hi all, Normal function of cardiac valves Four necropsy series5, 6, 8, 20 provide the only basis we have for estimating the incidence of bicuspid aortic valve in the adult population, as diagnosis by auscultation is insufficiently accurate and no relevant echocardiographic study has been published. They are located between the ventricles and their corresponding artery, and . James Cameron checks in from Pandora with a status report. 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. Lack of breath? Great article! Hes gained 25 pds . I like to practice MTB and running competitively in local races. If untreated, it can lead to blocked blood flow. triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? I am a 28yr old male, and Ive just found out about my BAV. I do think that aspects of the martial arts are strength-related. My aortic root is 4.06 cms. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Instead, even with continued sports participation, the progression of both valvular and aortic disease is no different from that in the general population. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). "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. This is ridiculous. He will be rechecked with an echo, BNP blood test & MRI every 6 months. Im not sure theres enough information at hand to offer sound advice. 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 recently also did a 24hr EKG (holter) which was fine. No information provided by Baldwin Publishing, Inc. in any article is a substitute for medical advice or treatment for any medical condition. "I am lucky to be here.". I wish you both all the best. Thanks for sharing your sons story with BAV. After an MRI, Ive been diagnosed with BAV and mild aortic coarctation. . I would like to know more about your recovery timeline since you are so much further out from surgery than I amfor instance; how long before you could do long rides again; when could you do tempo efforts; start high heart rate intervals; and finally race again? I am followed every 2 years. The aortic root is moderately dilated (max 46mm sinus to opposite commissure but you can measure 48off axis). In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. The timing is my choice.. Perhaps you could print out the diagram, take it with you to the cardiologist, and ask him/her to circle the forms of exercise that would be safe in your case. 4.2cm dilated aortic root We are now seeing moderate stenosis, hence replacement in the not too far distant future. Hello dear doctor. Maybe a genewho knows. Because BAV may be an inherited condition, Athletes with BAV, no significant valve stenosis or regurgitation, and an aortic diameterless than 4.0 cm can participate fully in their sport(s), Athletes with BAV and enlargement of the aorta to between 4.0 and 4.5 cm can participate safely in only low and moderate intensity sports (this would. Not only the degree of aortic regurgitation, but also the degree of enlargement of the nearby aorta, should be taken into consideration when settling on limits for exercise. 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. . This would be a major operation.and would certainly be invasive regardless of the particulars. Perhaps the doctor could contact the specialist and request an earlier appointment, if that made sense. Aortic regurgitation (also called aortic insufficiency), which is a leaky valve. Im in Philly today but Im from Central NY. I had to take time off gym, when I returned I only did light weights and only walking on the 4x a wk and the same issues where still there. The Jeopardy! Unfortunately his cardiologist took that from him so he focused his energy and talent on basketball. Its conceivable that an echocardiogram a week afterwards could be abnormal simply because of the race. Can you please shed some light on this is the sport performance supposed to gradually diminish (seems to go to zero for me) before the operation is needed? Bicuspid aortic valve (BAV) is a heart problem present at birth and the most common congenital cardiac anomaly, with an estimated incidence of 0.5 percent to percent in the general population. I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. Needless to say, the diagnosis was quite overwhelming. This is such an interesting blog, I wish I had known of it sooner. 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. Questions currently remain about how long such repairs will last and whether patients might require re-operation at some point in the future. 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. 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. The cardiologist doesnt do the surgery we have to go to another province to have surgery. They all cause a small bit of obstruction to blood flow as it leaves the heart. Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. Weight-lifting is only one example, but others would include golf, bowling, shooting, etc. ANYTHING other than walking and golf? Just still unsure however if my bioprosthetic valve affects my cross country running times. Hi Dr. Creswell. Latifah has taken on her mom's caregiving duties, along with relatives and a nurse, whenever she is on the east coast. That is to say, I did up until two months ago. 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. Now, fully healed thanks to two stents in her arteries, Lucci is spreading the word. Im not aware of studies explicitly about athletes after Ross procedure for BAV. Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. 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. 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. To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. Garth was already familiar with heart diease before her diagnosis because it runs in her family. It sounds like youve gotten conventional advice regarding sports where there is a risk of bodily injury. Thoughts. Have tried to get a personal trainer that specialises in all things heart related here in the UK but there don`t seem to be any around despite searching. The valve will become healed (scarred) into the surrounding heart tissues with the passage of time. Im paranoid to exercise too much for fear that I will do damage to the valve. I had a scan done recently and they picked up a what they called a mild dilation of the aortic root at 47mm, ascending aorta 34mm, no other issues. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). The BAV is monitored annually, the doctor told me that Im currently in the grey zone but stable since I started the monitoring. I used to do quite some running 10 years ago (still at amateur level), I was doing lots of 10k and 20k and even I managed a marathon in 3h:26min (but at that time I didnt know about the BAV). Me, i`m nearly 43, male and have BAV. In fact, in some people they can go undiagnosed for years. Learn more about Baldwin Publishing Inc.editorial policy,privacy policy, ADA compliance andsponsorship policy. Theres a saying if you watch a group of kids running around, you would never know who had a heart defect unless they lifted their shirt. This list, which may shock you, includes Olympians, Athletes, Musicians and more, all with an invisible illness. Willie Moses It makes the heart work harder than it should. Since then I completed several 10k races and one half-marathon. I do not feel any of the effect of my condition when I run or workout. 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. I made appointment with my cardio, to clear that up, dont worry :). I have appointment with a cardiologist on Friday but in the meantime i would like to know weather in case of surgery a replacement of the valve is definitely necessary or my condition still allows some options for a surgery without replacement. With the blood thinning needed for a mechanical valve, serious bleeding may occur with injuries. I have not had any issues since my surgery. I started experiencing palpitations last year along with several instances of light-headedness. Thank you to every doc and nurse on my team!". I have normal aortic size, mildly dilated aortic sinus (39 cm), and trace aortic regurg. This valve repair option is one that might best be pursued at a center that specializes in this problem. 1 year ago I gave up smoking and started endurance running. Normal biventricular size and function, no scar. Arnold Schwarzenegger (The Governator) - Heart Valve Replacement. (Yes, I have been going for regular check-up since in was about 7 years old. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection. with valve area of 1.4 cm2 and aorta of 4.1 cms Thank you for taking the time to respond to everyones concern. Could the changes in my LV be the result of the physiological, not the pathological change? A HR limit of 120 will be tough, I would guess. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. 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. Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. Bicuspid aortic valve. For some reason I did not receive a notification of your reply, so apologies that I havent thanked you before. Im 32 years old and didnt expect at all that my aorta would dilate. Post 2 years and Ive yet to get back to my high level of racing fitness and wanted to see what should be expected. 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. This has been true as long as I can remember in all sports I seem to have to put a lot more in to get the same out as others. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. 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. This has caused a Thoracic aortic aneurysm that is 4.3 cm. A bicuspid aortic valve (BAV) is an aortic valve that has only two leaflets instead of three. I dont have any ayptoms. Yes, as the patient grows, so will the aorta.and eventually you get to the traditional >40 mm cutoff where activity restrictions are advised. Hi, Further to this most recent discussion point I was advised that isometric exercises, such as planks and other pilates type activities, as I understand them, are perfectly safe with BAV. I dont know anything about crossfit but I see his times are average on that page. My problem is with cardiologists stating do not lift anything over 50lbs. Kimberly was born with an abnormal valve, but didn't begin to develop symptoms until her 40s. Hi Larry, Obviously, I underwent emergency surgery to replace the aortic valve (Medtronic open pivot mechanical valve) and have the aneurysm repaired with a dacron graft. I am perfectly happy to stick to the 10km max distance for races, but my key concern is that if I do run some faster training sessions then I might have a sudden death. 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. No aneurysm. Thank you for your time. His BAV is causing very little back flow. 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. 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 . Ive recently joined the gym to get fit an toned up but I cant get a clear answer from the cardiologist of what weights I cant actually do at the gym. This is an area where second opinions may be helpful in sorting out whats safe. Contact Editor. He would be devastated to never be able to play again. That said, the recommendations dont address WHEN that screening should occur. In both echocardiographic cohorts and surgical series, pure aortic regurgitation is significantly less common than stenosis. Bicuspid Aortic Valve The valve can gradually become harder to open or leakier . Thank you for what you do and for your responsiveness. The lines are the edges of the valve leaflets that open and close to let blood through. Anyway, I just wanted to say I found this article particularly informative. And judgment would be needed. In the blog post, I talked about the circumstances when operation is needed.as well as when sports are generally safe. Regarding the PEARS, the main concern is about the possibility that the aorta dissects even in a controlled measure (lets say 4.5cm). Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. Do you think I should slow down a little bit? I do not do any kind of sport and I want to have healthy life at make sure my situation not getting worse and I weight 90 kg. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. My cardiologist gave me green light for everything except strenuous exercise (used to train for ironman and similar challenges). As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Answers to your questions. The ST junction and ascending aorta are mildly dilated max 35mm. Great article! The value of CT/MRI comes when a millimeter or two makes a difference in treatment, restrictions, surgery, etc. September 13, 2017 1:00 PM. There are a multitude of patient-specific circumstances that must be considered when deciding if and when operation is needed. 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. His doctor did not restrict him, but suggested that it may be time to give up the high-level play due to its high intensity training aspect (based on the My questions are He also has minimal leakage at the valve aorta. I had my AVR almost one year ago. I guess my marathon training is officially over, but i hope that i still keep doing some sport and i dont mean bowling, no offense for who practice it ;). Probably wise to follow the advice of your doctors who know the details of your situation. there was a tiny strand of tissue on the septal aspect of the muscular LOVT (LCOT Vmax 2.1m/sec;20mmHg peak gradient. In Jan 2016 My son was seen by the cardiologist and had some changes on his echo and the cardiologist said hey had mild progression of the aortic regurgitation( moderate to severe) with preserved LV function. He has mild AS and AR and is otherwise asymptomatic. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. 3. Patients whove had aortic valve replacement and/or replacement of the aorta will require life-long monitoring by their doctor, with periodic echocardiogram and/or chest CT scanning. A bicuspid aortic valve is a congenital condition, meaning that people are born with two rather than the normal three cusps on their aortic valve. Many thanks again for answering this. Pop Medicine > Celebrity Diagnosis . It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. Many athletes with bicuspid aortic valve (BAV) may continue to participate in their sports.provided there are no other problems, either with the aortic valve or nearby aorta. I think you understand the guidelines correctly. He had a mild BAV and was told that he can play with no restriction. Also I lift weights . Also, again, no stenosis or regurgitation, 35 mm ascending aorta. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. Im highly considering this option, after 4 months of research and appointments with doctors. Thanks a lot for your answers. 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 have also been advised that running intervals at over 80% max heart rate would not be sensible. Is it right to declared someone having BAV unfit for the post of a chemist? Moderately dilated aortic root (max 46mm), mild ascending aortic dilatation. Do you opration? Almost 15 years ago skilled surgeons replaced my aorta valve with a new replacement valve. I would pose these questions to your doctor(s) since they are most familiar with the details of your situation. Most patients spend about a week in the hospital after operation and then are able to go home. We have decided to wait and watch. Aortic stenosis, the narrowing of the aortic valve. I had a cardio version to correct the AFIB.
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