The cardiologist doesnt do the surgery we have to go to another province to have surgery. Substitute valves. They all cause a small bit of obstruction to blood flow as it leaves the heart. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). (Have you heard of the studies by Dr. I think we should have a choice??? I cant imagine life without activity, but Im not fool to risk my life, not any more anyway :). I cant thank you enough for your responses to all the above questions. Surgeon Q&A: What is TAVR Valve-in-Valve? Something they suspect is also from birth but never previously picked up. I dont know why this formed as I have had the problem valve replaced many years ago. 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. 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 have been given no restriction to date in any physical exercise as my valve is in decent condition. I first wrote about BAV in a short post here at the blog back in 2009. Every 6 months it is getting larger. My resting HR is 60-70 BP 110-70, according to doctors have no tissue problems, never had hypertension and was told that I was born with weak threskupid valve. Seven months ago I had emergency AVR due to a BAV that was severely compromised by endocarditis. I did run 1-2 times/week for a 1.5 months now, the situation is getting a little better but still I feel like a 80 years old. This is thought to occur at a rate of about 0.1% per year in adults. Hey would like to continue to be active but is worried about which procedure would be best for him. running? So it's got the Rock and Roll Hall of fame and great doctors. Yes, there are certainly patients with BAV who never need operation. Does the (unreplaced) aorta enlarge over time? Ive yet to feel like Im back to my previous racing fitness that I once had. 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. Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. Thank you for your ideas and I apologize for my gramma errors (English is not my first language). I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. If he is a candidate for valve replacement are these sports he could ever return to In the best case scenario? The incidence of normally functioning bicuspid aortic valves is 0.6% to 0.9%.5 . He is very athletic. Celebrity. Patients need operation if there is severe stenosis or regurgitation of the aortic valve.or if the nearby aorta becomes moderately enlarged. This is true at rest and may be even more so during exercise. Arnold Schwarzenegger opted against a mechanical valve replacement and chose a tissue valve because he felt a mechanical valve might limit his physical activity and capacity to exercise. What is a TAVR? Kinda like a marathon but it will take me at least 9 hours. Robbie Benson - Actor/Director - Bicuspid Aortic Valve. A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. Thank you so much for your explanations, Im 30 years old with BAV 2 instead of 3 leaflets since birth, doctors recommended me to have Echocardiography test each year and so. On Aug 30, 2017 I passed out at the gym and subsequently airlifted due a large abscess and valve dehisence and underwent another operation and now have a homograft. He/she can talk with you about the generalities of operation in your circumstance. Periodic re-evaluation with echocardiogram and/or CT scanning is used for most patients in this circumstance. My question here is what is the damage I can cause to my heart, mechanical valve, if I keep my heart rate at hi intensity levels? "I had to make lifestyle and diet changes, she said. So it is very possible to continue athletic activities after surgery. A lot of people have it, she told Access Hollywood in 2009. The idea of somehow restricting the HR may be attractive as a means of curtailing strenuous activity. My 28, got a BAV with mild stenosis and a aortic root measuring 40mm. In fact, like most people, the 25-year-old had never heard the term before. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. I was running 9 to 10 minute miles. There has been a slight increase in the measurements over the last several years, but I am still below the threshold which would require surgical intervention. The lines are the edges of the valve leaflets that open and close to let blood through. 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 had a cardio version to correct the AFIB. September 13, 2017 1:00 PM. Aortic valve repair is sometimes possible. Copyright 2021-2022 Baldwin Publishing, Inc.All rights reserved. Easy bicycling might work, but I suspect that running wont be workable with that cap. Thats about as specific as he got. What should I do ? This is amplified when I sit with my feet up (male cross-legged) because of the tingling/numbness in feet. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan. Will I need surgery? 1. 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). However, his ascending aorta has been enlarging: 11/27/13 31 mm (echo), 6/10/15 39 mm (echo), 7/8/16 41 mm MRI). With aortic dissection, the aorta can develop a tear on its inside wall, leading to unraveling of its layers, and even rupture. As youve mentioned, sometimes it can be useful to visit a cardiologist who has an interest in athletes and their heart problems. Etc? Diagnosed last year while looking at something else. We briefly talked about the Ross procedure vs mechanical valve replacement. Im not familiar with employment eligibility issues with BAV, even in this country. Enlarged ascending aorta 42-43 mm I will keep you posted. Holding breath during lifts valsalva). Either way I often think my cardiologist looks at me as if Im nuts and that my current 175 miles a week training should be thought of as beyond expectations post open heart surgery. Sign up to receive an email when I add new content. Advertisement. Im not looking forward competitions nor marathons. Can you direct us to ANY research on the effect of endurance sports on AVR patients? If so, youre far from alone. At 4.0 cm, its important to be thoughtful about activities. Bethesda Conference reports), even though there is no certain link between sports and the aorta enlargement. 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. While she ended up being okay, she advised other women to be more cautious. 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. Ad Choices, Blood molecules as they exit the left ventricle: I'll be back., The 42 Best Romantic Comedies of All Time, The 25 Best Shows on Netflix to Watch Right Now. 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. Many of us are not familiar with the many types and facets of the martial arts. Your sons cardiologist would seem to be in the best position to offer specific advice. Body contact sports may pose some danger to athlete patients who take blood thinners. I was diagnosed age 4 and am now 35. Notify me of follow-up comments by email. What advise can you give to someone in my position? Does lifting weights up to 100 pounds and being cleared for push-ups, pull-ups, all cardio, etc., sound reasonable? Rest pulse (70 bpm|50 bpm) Several contemporary elite triathletes have BAV and Ive written about their stories in: Examples from other sports would include Arnold Schwarzenegger, among others. Patients with BAV who have a normal size aorta, with no stenosis or regurgitation of the aortic valve, can participate in sports without restriction. At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. when I discussed this with my Dr. he reassured me that its not my heart causing it. You are a very good man. This can be a life-threatening problem and is more apt to occur with progressive enlargement of the aorta and with uncontrolled high blood pressure. 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. The surgery was a full success, and the valve is closing really well now. This almost seems like an off the shelf answer and Id therefore be really keen to find out your thoughts? And judgment would be needed. I see my cardiologist the end of May. 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 . Ive done the Philly a Marathon a coup,e times and know that its a terrific event. 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. Im 52 years old and had surgery 2.5 years ago to repair an ascending aortic aneurysm (5.8 cm) and aortic tissue valve replacement. 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. I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. Thanks. 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 . Athletes will ask when they can return to their sports. My cardiologist gave me green light for everything except strenuous exercise (used to train for ironman and similar challenges). For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. 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. To continue to live this amazing life so full of challenges and friends, including so many of you in the audience, I have chosen to replace the valve with a new one. Its weird because sometimes when Im resting I can feel a little weird fluttering.. Obviously, I underwent emergency surgery to replace the aortic valve (Medtronic open pivot mechanical valve) and have the aneurysm repaired with a dacron graft. Im used to long runs up to 12 miles at an average 6 minute per mile pace as well as fast interval and farther training. John Ritter - Actor - passed away due to undiagnosed CHD at age 55. 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. From your standpoint (and your sons), it will be important to have that dialog to sort out whats safe. E. G. I could bench 50lbs with no need to strain and hold my breath, which wouldnt result in a massive spike in blood pressure, but if I tried to bicep curl 50lbs it would do. Bicuspid aortic valve. He left it pretty vague. Are there any things I can do now to help minimize my risk? Im 39 also diagnosed with BAV when I was 31. I applaud your efforts to search out information to help you decide on a course of action. Its very helpful for people with heart problems. Eventually I will need valve replacement. Dont see why HIIT should be excluded. Exercise and sports are usually safe if there is mild aortic root enlargement but no other heart or vascular problems. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. 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. Regarding the PEARS, the main concern is about the possibility that the aorta dissects even in a controlled measure (lets say 4.5cm). I want to continue weightlifting .. what is your opinion about this ? The American College of Cardiology (ACC) in conjunction with the American Heart Association (AHA) has issued guidelines for the evaluation, monitoring, and treatment of individuals with BAV: In my opinion, these are useful guidelines for athletes and non-athletes, alike. My personal approach to endurance athletes in this situation would be to offer operation if the patient wanted to continue to participate in endurance sports (after operation) and was willing to assume the risks of operation. 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. 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. In January 2021, she underwent open heart surgery to install an aortic valve. Since he had to stop playing.. depression has set in. 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. Thank you for taking the time to respond to everyones concern. (Or do I just need to train even harder??). My son is 16 years old and his story is very similar to many I read on your blog. Hi Dr. Creswell. I understand that we are only beginning to learn about the use of ARBs in patients who DO NOT have connective tissue disorders like Marfans syndrome. My son is desperate to be able to play sports without any restrictions. This year he was told he couldnt do heavy lifting but all other sports are still ok. My son seems to sprain his ankles or have other injuries often that last longer than others kids, I also played sports and had injuries but they never lasted as long as his do. I am now 60. Great article! Congrats! I have not had any issues since my surgery. Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. The flaps are called cusps. An echocardiogram last June revealed a function BAV. It might be wise to have discussion with your doctor about the particular activities youre concerned about. However, I always performed poorly when it came to the top end fitness tests e.g. Benefits: long-term durability. As I train triathlon I check my heart every year and there is small back flow (the same last 5 years). My son was also complaining of shortness of breath with stairs mild and feels tired more easily. I dont believe this has been well studied. Should I be doing push-ups/pull-ups? He posed next to statues of Thomas Jefferson, Jesse Owens (whose family moved to Cleveland when he was nine, and who later attended The Ohio State University), and Abraham Lincoln. There have been reports of lingering effects (decreased function of the left or right ventricles) for several days after marathon runs. Thanks for sharing the article about the PEARS technique. There, Lucci learned that she had a 90 percent blockage in the main artery of her heart and a 70 percent blockage in another, and needed emergency surgery. Youre right, though. 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. I feel like 95% of other people my doc sees are just happy to get back to their normal life which doesnt include pushing their bodies to extreme limits. We go back in 3 months for another echo. 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. Get your act together, Columbus! For athletes who return to sport after AVR and aortic replacement, its important to settle on whats safe with your doctor(s) ahead of time. It sounds like youre off to a good start with your recovery. Unfortunately, I really cant point you to such studies. Historically, a heart murmur was the most common reason affected individuals were identified. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. This is the only measurement that has gone down . While I no longer due very strenuous activities, I still play softball, golf, kayak, ski, and do play hockey every now and again. I have ramped up my walking to 30 minutes, keeping my heart rate under 100 bpm. These are the data I got in my last MTB race. No changes in regurgitation status (aortic regurgitation LVOT 19%); The guidelines do not address the frequency of surveillance for individuals with BAV and no enlargement of the aorta. I have been doing this for the last 5-6 years now and am hopeful it can continue. Is a CT or MRI absolutely necessary for measuring the aortic diameter? How are you? I can imagine it might be difficult to make arrangements when you live in one country and your doctor(s) work in another. Im hoping you can help with some guidance. There are certainly individuals with BAV who never have trouble down the line. My primary question relates to sports. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. 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. 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 video is just 1 min 42 sec long. Ordinarily, athlete patients with mild degrees of valve regurgitation can continue to participate in their sports. Sory but I dont speak very vell english. Im just going to do my very best to stay the course and have annual echoes to track my valve. The only question I have is in regards to having my children screened. I had a David Tirone Operation a couple of weeks ago to repair a BAV with aortic dilatation (49mm), and a small leakage. Thanks in advance. I have question about your opinion about aortic valve regurgitation (no BAV) swimming? Without careful study, I dont know what the true risks will be. While I do expect to have a replacement done later in life, the repair was the best decision I could have made. My daughter (16 y/o) has a St Jude mechanical mitral valve (adult size valve even though she has had it for 7 years). No thrombus, vegetation were noted Zdenko . 2. 1, 2 Much of the data relating to its complications derive from necropsy studies since reliable . A bicuspid aortic valve is a congenital heart defect that affects the one-way valve between your heart and your aorta, known as the aortic valve. Some information about myself: Im 28, 186 cm, 77 kg, max pulse 194, rest 50 bpm, live in Russia. I used to run a lot. To list down the names of celebrities including entertainers, musicians, politicians, TV personalities, sports figures, etc. 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. I am a 60 yo female who has been active my whole life. Health eCooking is a registered trademark of Baldwin Publishing, Inc. Cook eKitchen is a designated trademark of Baldwin Publishing, Inc. Any duplication or distribution of the information contained herein without the express approval of Baldwin Publishing, Inc. is strictly prohibited. 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. Thank you for the blog that addresses the athletes point of view, and feelings. 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 . And my wife is screaming at me every time I try to exercise :)). At this time, it is not known whether Arnold received the new valve using a surgical aortic valve replacement (SAVR) or atranscatheter aortic valve replacement (TAVR). 140 miles at race pace. Today, echocardiography (ultrasound) for screening or diagnostic purposes for some other heart problem is the most common way that BAV is detected. From afar, I dont have much to add. At the age of 12, she had a procedure to widen her valve as her heart condition continued to have an impact. The pitfall, though, is that our native aortic valve is itself very efficient. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. What does heavy weights mean? Do medications like beta-blockers limit any potential harm? Lastly, a human donor valve was inserted into the pulmonary valve position. I exercise, eat well and keep my weight down. Some people with bicuspid aortic valve will have symptoms in early childhood. Its always good that investigators are looking for new solutions to old problems. 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. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. Is the biggest risk (from numbness) a over-calcified valve which would cause lack of blood flow? Many congenital heart defects cause few or no symptoms. Thank you to every doc and nurse on my team.". I had AVR exactly 1 year ago to the date. my son has BAV he was born with. They all cause a small bit of obstruction to blood flow as it leaves the heart. I wonder if there is also a psychological factor involved. I did cardio training 3 times a week and weight training twice a week for 60 years. O'Donnell suffered a heart attack in 2012, and wrote about her experience on her blog. Thank you for what you do and for your responsiveness. (bicuspid aortic valve), singer Bret Michaels (atrial septal defect), and even 'Survivor' contestant Whitney Duncan (ASD). 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). Or usually lead a normal life? I know I will need it replaced. But neither of these procedures are durable for the long-term. Im not sure I have all the answers from afar. From afar, its hard to know what might be responsible for your symptoms. We are trying to work out a way for her to continue to play. They ruled out Marfans syndrome because his aorta was dilating. 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. Baldwin Publishing, Inc. strongly suggests that you use this information in consultation with your doctor or other health professional. SPORTS FIGURES/ATHLETES. The aortic valve allows oxygen-rich blood to flow from the heart to the aorta. Im a 42 year old male and have been a highly competitive distance runner since high school. 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. There are many causes of light-headedness and chest discomfort that are not related to the heart. For me, its about gender equality. Perhaps other readers will comment. Normal biventricular size and function, no scar. The pertinent questions for your cardiologist is whether there is any stenosis (narrowing) or regurgitation (leakage) of the aortic valve and whether the size (diameter) of the nearby aorta is normal. He wants to be normal. 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. 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). Catch up on the years best movies, whether in theaters or now streaming at home. Theo Wargo/Getty. Likewise, if I did a 60kg bench press I could easier than say an 18 year old girl started at the gym tried that, they would have to strain beyond belief. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). Unanswered questions include: Can a bioprosthetic valve wear out more quickly than expected? Thank you so much for your clear explanations. 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. 27yr old male. Fox News anchor Bret Baier has a . 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. Is strength training that involves only using ones own body weight ok with mild BAV issues, or is all strength training out? In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. A total of 25,556 newborns (51% male; mean age, 12 days) underwent echocardiography. I was only diagnosed with BAV after a routine examination and only because my company has increased in size above a threshold at which all employees are supposed to be subjected to this examination (weird law in Belgium). It makes the heart work harder than it should. 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. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Again, this is a topic that is not yet well-researched. 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