Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). James Cameron checks in from Pandora with a status report. Only two cusps, commissures and sinuses are seen in the less common "pure" bicuspid aortic valve subtype. I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. This gives a chance for the sternum, which was split during the operation, to heal completely. My resting pulse is 55 and BP 115/82. When patients have moderate to severe aortic regurgitation, exercise can often be difficult. I have ramped up my walking to 30 minutes, keeping my heart rate under 100 bpm. Best Valentine's Day Restaurant Specials 2023. While I do not work out regularly, my job as a construction worker is somewhat strenuous. Bicuspid aortic valve (BAV) is a genetic condition that causes the aortic valve to have two leaflets instead of three. 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. Hi Larry, 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 4.2cm dilated aortic root My performance as a cyclistgiven my ageputs me in the elite category, although with the stenosis I am experiencing a definite decline in performance. I have normal aortic size, mildly dilated aortic sinus (39 cm), and trace aortic regurg. ( I was much worse though). Whether 130 beats per minute is a good cut-off truly isnt known. 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. If echo shows a normal size, thats probably okay. Current guidelines suggest no restrictions on activity for athletes with BAV who have no stenosis/regurgitation and who have a normal sized aorta. If the valve does not close completely, blood can leak into the heart. Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. Do you think the jiu-jitsu (e.g. His cardiologist said he cant play. 1 year ago I gave up smoking and started endurance running. Maybe a genewho knows. 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. 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. I was just curious if there any way to know if my valve is affecting my times at all? 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. What have I observed and learned in the quarter century since? Lynn. Regards Also I seemed to get quite sweaty the following hours after a hard training session. At issue are the potential long-term effects of repeated episodes of high heart rate and high blood pressure that accompany intense exercise. Who Qualifies for TAVR. All Rights Reserved. Is this a possible explanation? I want to continue weightlifting .. what is your opinion about this ? Aortic regurgitation (also called aortic insufficiency), which is a leaky valve. 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. When he was 7 we noticed his heart racing at age 11 his bicuspid aortic valve was diagnosed We have been told his valve is at the top of the normal size chart. We have got two completely different opinions from our cardiologists: Your web site and the links have much good information. The singer co-founded the Womens Heart Alliance, which works to raise awareness and funds research to fight womens heart disease. In the simplest terms, a bicuspid aortic valve can be a serious heart valve disorder in which the valve only has two leaflets, or flaps, that control blood flow through the heart. These operations can sometimes enjoy the benefits of each of the operations you mentioned.and avoid done of the down sides. Hi Dr. Creswell. For some reason I did not receive a notification of your reply, so apologies that I havent thanked you before. I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. Great article! I have been given no restriction to date in any physical exercise as my valve is in decent condition. Does the (unreplaced) aorta enlarge over time? With aortic root 39mm. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. I hadnt heard about the technique previously. 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. Hi. Many people in your situation will eventually need operation for replacement of the valve or the aorta, but wed need a crystal ball to know about the future. 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 have been feeling better than before the surgery and I feel with better condition on the trails. The video is just 1 min 42 sec long. I dont know why this formed as I have had the problem valve replaced many years ago. 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. Good to hear that youre making a good recovery from your second operation. However, I always performed poorly when it came to the top end fitness tests e.g. mod-severe regurgitation They call this type of heart attack the Widow Maker," she wrote. SPORTS FIGURES/ATHLETES. 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. Just a short info for whomever may read, I searched for Tims name and I found this page: "I am lucky to be here.". (I am on a low dose beta blocker) Prescriptions for safe exercise will need to be carefully tailored to your particulars. Have completed an excercise stress test and signed off as ok on reaching level 13. Parenthetically, it may be time for an update. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). Thank you for the blog that addresses the athletes point of view, and feelings. We just saw them in January. 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. I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. He also has minimal leakage at the valve aorta. Bicuspid aortic valve (BAV) is the most common form of congenital aortic valve disease, in which the valve has only two leaflets instead of the usual three; it affects up to 2% of the population. will need careful consideration by your physicians who know all of the pertinent details. Dr Creswell, My cardiologist is not concerned. 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 do think that aspects of the martial arts are strength-related. I have completed two marathons. I have also spoken with Boston Childrens Hospital who have been very helpful and enlightening. Thank you for best websit. Perhaps other readers will comment. What advise can you give to someone in my position? 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! All they said is dont really do weight where you can feel the strain in your neck ?!? "Until then, stay close.. Im not sure how those two problems would be related. At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. I got checked out by my GP who detected a murmur then had all the other heart related tests and was diagnosed with BAV with stenosis and regurgitation. 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. In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. It can also lead to aortic stenosis , and is more . With aortic dissection, the aorta can develop a tear on its inside wall, leading to unraveling of its layers, and even rupture. It is unclear however if there are cardio thoracic surgeons who perform minimally evasive repairs yet. There are many surgical options depending upon the particular circumstances. I had a cardio version to correct the AFIB. celebrities including musicians, actors, TV personalities, politicians, entertainers, and sports figures, etc. I love running. Left Ventricular Mass (LV mass/BSA 93g/m2| 114 g/m2, Septal thickness 0.93 cm|1.0-1.1 cm, Posterior wall thickness 0.93 cm|1.0 cm). Tetyana. Needless to say, the diagnosis was quite overwhelming. What is a TAVR? The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube. Fast forward, he is now 13 and we went yesterday for his yearly. 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. ODonnell, now 54, said her heart attack began after she helped an enormous woman struggling to get out of her car in a parking lot. I am a 23 year old male, have BAV with mild AR. About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. Use of this site constitutes acceptance of our User Agreement and Privacy Policy and Cookie Statement and Your California Privacy Rights. I have only trivial aortic regurgitation. A 2019 report suggests that bicuspid aortic valve disease is the most common congenital heart valve problem, affecting between 0.5 and 2 percent of the general population. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). Thank you,dr Creswell, He has been restricted from playing contact sports since hey was 10. For his second operation, Arnold Schwarzenegger, who was 70 years old at the time of this operation, had a pulmonary valve replacement procedure performed at Cedars-Sinai Medical Center in Los Angeles, California. 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. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. I take BP medication namely Amlodopine & Ramipril which has lowered my BP. Baldwin Publishing, Inc. strongly suggests that you use this information in consultation with your doctor or other health professional. I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. 2023 Baton Rouge Clinic. BAV was diagnosed in 196 newborns (prevalence, 0.77%), with a male-female ratio of 2.1:1. First, youre not alone! We expect the current generation tissue valve to last at least 12-15 years before problems. Most children with BAV will remain without symptoms until adulthood. Barb. 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. 2k erg test. I am a 48yo competitive cyclist who is very concerned with being able to return to my former ability to hit high effort levels following open heart surgery. Body contact sports may pose some danger to athlete patients who take blood thinners. Great article! Can you tell me what is to much, are push ups or pull ups heavy lifting, is 3 time per week 5 km running with 10-12 km/h pace to much? I dont train a lot, like 2k bike, 500k run and 100k swim yearly and few competitions sprints and one half IM in a year (32 years old). This is an area where second opinions may be helpful in sorting out whats safe. She said it could still be 6 months to a year just depending on if there are any more changes to this next echo. My heart seems to heal, so that speaks well for my future.. My aortic root is 4.06 cms. So unfortunately it sounds like i am part of that grey area. http://www.24hourgym.us. 1, 2 Much of the data relating to its complications derive from necropsy studies since reliable . Aortic Stenosis In addition, I will get a random bout of lightheadedness when standing or sitting in a awkard position. John Fox, NFL coach, suffered from Aortic Valve Disease. Advice in this area must be individualized with your doctor(s). They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. However, I absolutely love being competitive at running, and dont want to jeopardize that either. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection. Normal function of cardiac valves 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 . Perhaps meeting with a heart surgeon now, even if operation is not yet needed, might provide a forum for discussion about the options for surgery, the technical issues, and recovery. But Ill check it as soon as possible. Bicuspid aortic valve can be found in 1% to 2% of the general population . Males are affected 3:1 compared to females. I just want to know what things I will see change so that I dont look past the change in my valve and miss my window to get the valve replaced. In patients needing valve replacement because of stenosis or regurgitation, the aorta should be repaired or replaced if the aortic diameter exceeds 4.5 cm. Shes quite the athlete. How severe are the problems? I am 18 years old . . On said it wont make a real difference, the other said oh yes, that was like a blockage, you will feel the difference. Best to continue to work towards identifying cause(s) and getting any needed treatment. Adam has been featured by the American Heart Association and Medical News Today. Almost 15 years ago skilled surgeons replaced my aorta valve with a new replacement valve. 1) What kind of sports are recommend to me according to my situation? Replacement? Thats an issue to pursue with your sons doctor(s). my age is 20 right now I now take diltiazem daily. The data regarding the progression of disease in athlete patients with BAVare limited. I found a cardiologist with whom Im quite happy with. The best source of recommendations about safety of various forms of exercise will come from your doctor(s) who are familiar with all the particulars of your circumstance. New guidelines from the American College of Cardiology (ACC) were published just this week. Most patients (like me), however, start to experience problems during their 30s, 40s, and 50s. Here are some celebrities that experienced severe heart valve defects and had to have either heart valve replacement and heart valve repair surgery. Could the changes in my LV be the result of the physiological, not the pathological change? Im not surprised that youve received a conservative recommendation about exercise. Did you run? Enjoy! Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. I see Im not alone. Finally some solid information about exercise and life post AVR, thank you very much for that. If you suspect you have a heart issue, either because you have symptoms or a family history of heart problems, see a doctor. with valve area of 1.4 cm2 and aorta of 4.1 cms Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. There are certainly athletes whove returned to their sports after valve (and aorta) repair/replacement. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). Aortic stenosis has been reported to occur in as many as 72 percent of adults with a congenital bicuspid aortic valve, with peak incidence occurring in the 5th and 6th decades of life. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. 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. It sounds like youve gotten conventional advice regarding sports where there is a risk of bodily injury. Review of the clinical records of 152 patients aged 20 years and older found to have a bicuspid aortic valve at autopsy revealed aortic stenosis in only 28 percent. Dr. Creswell looking forward for healthy life without surgery any possibilities??? March 7, 2023, Rob Riley I like to thank you in advance for reviewing my question and also, thank you for such a great blog. I have recently found out that I have aortic regurgitation will soon be needing surgery. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. This was caused by an aneurysm in the ascending aorta (root) that measured over 6 centimeters). Im 31 and 1 years ago i found im BAV with modrate AI. Bicuspid aortic valve is a common congenital anomaly but does not cause functional problems unless aortic valve stenosis, aortic valve regurgitation, aortic root dilatation, or dissection or infective endocarditis occurs. For example, his spurt in enlargement happens to coincide with his spurt in growth. Common symptoms include chest pain, shortness of breath, dizziness and fainting. 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. The incidence of bicuspid aortic valve and complications. Would this constitute as too much in your opinion ? Abstract. Is operation needed? Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. My cardiologist has told me that, based on how my heart sounds, he doesnt think hell ever have to operate on me. My son was also complaining of shortness of breath with stairs mild and feels tired more easily. Both are important in deciding if and when operation is needed. This is ridiculous. Or, is it something that can wait until they get sports physicals in their teens? You can see my post above, from 26th of april. Have you considered meeting with a heart surgeon to talk about the situation? Males are about twice as . I would very much appreciate your opinion weather he can continue his regular football training or should stop it. How are you? You are correct that we worry about the influence of such activities on the enlarged aorta in those with BAV. I can not be on anticoagulant medications on the fire department. The doctor said she would see if she could talk about his case with the surgical panel but she said even if he did have surgery he couldnt have a career in sports??? The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. I met an old guy once after a run and he described me very well his running experience; he said when I accelerate, Im the only one to know. I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. Since Im very active in sports, Id like to have your opinion on it. 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. 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. He sees his cardiologist every year. He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. Mild aortic valve disease without symptoms may only require frequent health checkups. Aorta diameter (34 mm|34 mm); 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 see my cardiologist the end of May. I had a David Tirone Operation a couple of weeks ago to repair a BAV with aortic dilatation (49mm), and a small leakage. The important considerations in athletes with BAV are the degree of regurgitation of the valve and the degree of enlargement of the aorta. Please help me . There are many causes of light-headedness and chest discomfort that are not related to the heart. And what would moderate weight lifting be defined as? Do medications like beta-blockers limit any potential harm? For athletes with mechanical heart valves, the most important consideration is usually about potential bodily injury while taking blood thinning medications. That is except for the last two months hes had several illnesses ( influenza, bronchitis, URI). Answers to your questions. 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. As of Monday, my BP at the echo appointment read 115/66. Most probably not pericarditis cause I had it once so I know that pain type, but again, maybe its some other type. What Is Bicuspid Aortic Valve Disease? I dont have any ayptoms. Seek different pediatric cardiologist/hospital (we have not seen a cardiologist yet)? But for those WITH such problems, we do recommend curtailing either static or dynamic activities, or both. Well, as it happens, the Cleveland Clinic has been recently rated the top heart hospital in the nation, and the number two hospital overall. 3. There are a lot of variables here, even from the short story youve shared. I cant thank you enough for your responses to all the above questions. I am a marathoner with BAV and no other cardiac issues. I am a competitive cyclist, neither the Cardio or my Doctor said I should not be racing bikes anymore, does that sound reasonable to you, my doc did say to monitor the aortic root size yearly. I cant distinguish if its muscle pain or somewhere inside chest, its not sharp or dull, somewhere in between. Last i took him for the check up and everything is still the same but they said now the guidelines has changed and he is on the borderline of Mild to Moderate which will move him to restricted activities. Having a congenital heart defect means you are born with a problem with the hearts structure. http://games.crossfit.com/athlete/39565 Rest pulse (70 bpm|50 bpm) And now my aortic root is 42 mm. Thanks for the very insightful post, and for taking the time to reply to everyone here. While my surgeon said that I can do whatever normal healthy person would do my cardiologist gave me some restrictions basically not to raise my HR over 120. 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 . Ordinarily, race walking is considered to be in the same category of activity as long-distance running. 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. (Or do I just need to train even harder??). These techniques are most applicable to situations in which there is regurgitation, rather than stenosis, of the valve and when there is also enlargement of the aorta. Last week I visited a doctor and here are the changes for the last year (before|after): Thanks. 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. This would be a major operation.and would certainly be invasive regardless of the particulars. Dear Doctor,