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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. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). Normal function of cardiac valves Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. Is that so, or can it be measured by the echocardiogram as well? My sinus of valsalva is at 4.8 and my BAV is functional (discrete regurgitation). I am a 28yr old male, and Ive just found out about my BAV. Hi, my name is Hector and I am 34 years old. Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. Stories of Bicuspid Aortic Valve. Bobbie. Athletes will ask when they can return to their sports. 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. I had AVR exactly 1 year ago to the date. I am mostly a runner, 4 times a week, with 10 21 km races. I am healthy, strong, and active. What Is Bicuspid Aortic Valve Disease? New guidelines from 2015 are in accord with your doctors recommendations about vigorous exercise as well as periodic imaging to measure the aorta. I asked her about surgery. Baldwin Publishing, Inc. strongly suggests that you use this information in consultation with your doctor or other health professional. There, they detected I had a bicuspid aortic valve." This meant the valve which controls the flow of blood from the heart's left-ventricle chamber to the main artery had only two flaps instead . His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. Those with symptoms are usually identified (BECAUSE of those symptoms) in the first year or two of life. I would really like to know if I can (or shouldnt) push myself as hard as I used to. The studies on Irbesartan for Marfans(I dont have Marfans) are showing some positive outcomes; and. I am now down to seeing my doctors every 3 years or so and have been doing very well. 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. But thats just anecdote. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. To the extent that any operation fixes the stenosis or regurgitation, we might expect better efficiency from the heart. Weve known the risks and my daughter has done well to avoid scrapping for the ball etc. Would you recommend taking beta-blockers at this stage? 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. They are also predisposed to enlargement of the ascending aorta, the large blood vessel that carries blood flow away from the heart. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. If you suspect you have a heart issue, either because you have symptoms or a family history of heart problems, see a doctor. 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. Dr. Larry, thank you very much for your blog! 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. After 5 years of amateur competitive rowing, I had no problems keeping up with my peers whilst training at lower intensities. Even if its one person I help. Very much appreciate this site, thanks Larry for giving people like us a place to voice our concerns ! Historically, a heart murmur was the most common reason affected individuals were identified. I have moderate to severe regurgitation and the heart is enlarged as far as I understood. Perhaps that info will give you some basis for discussion with your cardiologist and surgeon regarding the type of valve that is used for your re-replacement. To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. 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. Average STS score was 1.7%. 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. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. But I recognize that not all cardiologists or heart surgeons would agree. Flaps of tissue on the valve open and close with each heartbeat. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Etc? Thanks for sharing your experience, Randy. You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. Is this a possible explanation? 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 young with many years ahead, I dont want to accept this just yet when I know theyre is possibilty of repair. Bicuspid valves are quite common (1-2 percent of the population). 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. 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? Perhaps the doctor could contact the specialist and request an earlier appointment, if that made sense. We just saw the cardiologist in July and again same symptoms and no significant cardiac changes . running? Bicuspid aortic valve (BAV) is a genetic condition that causes the aortic valve to have two leaflets instead of three. In my early 40s I thought that I was getting out of breath more than I should and eventually began to feel weak or nervous during a game, but only on Sunday. 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. Im 33 from UK and have known about my BAV since I was around 18. I have an OnX mechanical valve. I have found in my case( an athlete with bav)the typical response from doctors is, thats life, you cant do it anymore, be grateful for what you have. Since then I completed several 10k races and one half-marathon. Coarctation of the aorta is a narrowing that may produce an increase in the blood pressure in the upper extremities. Most probably not pericarditis cause I had it once so I know that pain type, but again, maybe its some other type. Left ventricle (LV diastolic diameter 54mm|58mm, LV diastolic volume 142ml|167ml, LV systolic volume 39ml|57ml, Ejection fraction 72%|65%); Could you express your opinion on this issue? While she ended up being okay, she advised other women to be more cautious. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. No stenosis or regurgitation, aorta 27 mm at the time. He has mild AS and AR and is otherwise asymptomatic. I am followed every 2 years. I would just like to share my experience of having a Aortic Valve replacement. O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. Routine endocarditis prophylaxis is . And its always valuable to frame up discussion in terms of how much risk is acceptable. I was shocked. Bicuspid Aortic Valve with trivial AR. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. Many congenital heart defects cause few or no symptoms. Many heart conditions can be controlled or repaired once theyre diagnosed. Business, Economics, and Finance. Kim Kardashian Doja Cat Iggy Azalea Anya Taylor-Joy Jamie Lee Curtis Natalie Portman Henry Cavill Millie Bobby Brown Tom Hiddleston Keanu Reeves. We have made the decision to stop playing high school soccer and will reevaluate in 6 months to determine about Spring team soccer (less intense). Bicuspid Aortic Valve - Symptoms, Diagnosis, Treatment & Surgery 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 so much. The numbness/tingling has me constantly worriedand the slight chest pains have me always thinking is that my BV or Aorta causing issues?. The timing is my choice.. Who Qualifies for TAVR | Eligibility and Treatment Guidelines I was diagnosed with BAV, with regurgitation, no stenosis, at age 63. Im 32 years old and didnt expect at all that my aorta would dilate. 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. Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? In the blog post, I talked about the circumstances when operation is needed.as well as when sports are generally safe. A different set of. my son has BAV he was born with. I would prefer not to stop. Do you have any info or recommendations about this? Thanks! Dublin teen to compete in Irish Dancing World Championships after heart 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 wouldnt be happy just running I want to be the best that I can be at it. Well, as it happens, the Cleveland Clinic has been recently rated the top heart hospital in the nation, and the number two hospital overall. This is an area where second opinions may be helpful in sorting out whats safe. 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. There is recent interest and experience with aortic valve repairinstead of replacementfor patients with BAV. However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. Do you opration? She says now it is stable and I dont have to see her for 2 years. Like you, I have been frustrated by the lack of experience and information that the cardiology community has for folks like us, although it is encouraging to read everyones posts here and see that we are not alone. Adam has been featured by the American Heart Association and Medical News Today. Frontiers | Transcatheter Aortic Valve Implantation in Sievers Type 0 Bicuspid aortic valves are more common in men, but also affect women. We also sign a school waiver every year. thanks for sharing all this interesting info. Please help me . . Hi Larry, 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. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. They ruled out Marfans syndrome because his aorta was dilating. 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 Thats important to keep in mind. Did you run? This is the only measurement that has gone down . Very likely an operation will be needed at some point in the future. I do not feel any of the effect of my condition when I run or workout. With so many similar stories, do you know why there is not more statistical data or studies done with regards to sports and BAV and changes in aortic diameter? Your surgeon will be in a good position to understand the exact details of operation that might be relevant when deciding whats safe.. Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. Notify me of follow-up comments by email. http://www.24hourgym.us. I have: I eat relatively well, but sometimes having those pizzas and burgers late at night I had to change that.. 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. Okay to wait? Normal pericardium, no pericardia effusion Tetyana. We just saw them in January. Bethesda Conference reports), even though there is no certain link between sports and the aorta enlargement. 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. Also, my next appointment is, unfortunately the week after my next marathon (which I will be pacing and not racing). Aortic valve replacement is recommended for nearly all patients with severe valve stenosis (valve opening less than 1.0 cm2), Aortic valve replacement is recommended for patients with severe valve regurgitation if there are symptoms due to the regurgitation (eg, shortness of breath with exertion) or evidence that the heart is suffering because of the regurgitation (enlargement of the left ventricle), Repair or replacement of the beginning portion of the aorta is recommended if there is enlargement of the aorta to greater than 5.0 cm. Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window). Benefits: no blood thinning (with attendant risks) needed. Bicuspid aortic valve (BAV) and congenital aortic stenosis are two types of heart defects that may be present at birth. I had surgery when I was 10 years old to replace my bav with a St.jude mechanical valve. Dietz?) I am 18 now, and I am interested in weight lifting. Arnold Schwarzenegger's Heart Valve Surgeries (2020 Update) Your site has been helpful in provided a sense of peacebut an extra insight would be super encouraging. Anything you can offer up here would be very much appreciated. It is very frustrating as my doctor would prefer to see me live the rest of my life with restrctions and have the aneurysm stabilized rather than take a chance on surgery and possibly returning to my normal lifestyle. My cardiologist Said to not lift heavy weights. Aside from the problems with aortic valve stenosis or regurgitation or with enlargement of the aorta, individuals with BAV can also suddenly develop the problem of aortic dissection. Celebrity. I would like nothing more than to have this repaired so I can return to my lifestyle, I cant understand why I cant have it fixed as it is my choice to have surgery. Prevalence of Bicuspid Aortic Valve in Newborns If you havent yet seen a surgeon, perhaps a visit would all wan opportunity to talk about these issues, even if operation is not yet needed. 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. I feel fantastic and have already been walking the streets of Cleveland enjoying your amazing statues. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. Some information about myself: Im 28, 186 cm, 77 kg, max pulse 194, rest 50 bpm, live in Russia. Im am in stres ?! My son is 12 years old. From afar, I dont have much to add. Im a 42 year old male and have been a highly competitive distance runner since high school. Mayo Clinic Q and A: Treatment and management of bicuspid aortic valve Then, a Dacron fabric tube can be used to reconstruct the aorta, in a so-called valve-sparing aortic root replacement. Aaron Boone (@AaronBoone), famous baseball player suffered from Bicuspid Aortic Valve. They are able to see my son this Friday, which i am much more comfortable with! His cardiologist told him to focus on basketball. Although we still dont have very long term results tracked (15+ years), in the short term the results seem to be much superior to regular bentall de bono option (and its variations). Arrhythmias may sometimes manifest many years after surgical repair of congenital heart defects. Hi Dr Creswell, . Thank you for what you do and for your responsiveness. That means it is a congenital heart defect. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . How much exercise is too much for someone with a functional BAV? Celebrities with Bicuspid Aortic Valve - Diseasemaps I found a cardiologist with whom Im quite happy with. Its also clear-cut that patients with significant enlargement of the aorta to greater than 5.0 cm need operation for replacement of the aorta. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . Your suggestion about a 2nd opinion is a good one. ps. 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. At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. They included a web link to the European medical guidelines. Thank you for your time. Use or viewing of any Baldwin Publishing, Inc. article signifies your understanding and agreement to the disclaimer and acceptance of these terms of use. Advertisement. Many thanks. I knew none of this until a year ago. 2k erg test. Answers to your questions. After the scans, ultrasounds, stress tests and TOE, I was diagnosed with BAV with no Stenosis, no Aortopathy and no evidence of Coarct and normal LV size and function. Now at 74, and after having AVR I am 10 weeks into the dont lift more than 10 pounds restriction. I continued playing hockey routinely until I was in my late twenties. Is that far fetched? It will also be necessary to keep a close eye on the size of the aorta over time, using echocardiography and CT. 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. A Public Death: Bill Paxton's Death Certificate Points To Surgery's Questions about Bicuspid Aortic Valve!! : r/AskDocs I am an having trouble seeing the difference in the ross procedure and the bioprospthetic valve replacement as far as benefits go? The potential downside relates to durability. I have 6 years to go to retirement at the very least. 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. Bicuspid Aortic Valve | Circulation If you wont we can share experiences about healing and progress, its pretty much same situation. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. Robbie Benson - Actor/Director - Bicuspid Aortic Valve. Common symptoms include chest pain, shortness of breath, dizziness and fainting. From your standpoint (and your sons), it will be important to have that dialog to sort out whats safe. I have also had a stress test, which showed no issues at all. James Cameron checks in from Pandora with a status report. Since Im not close to good medical care, are their specific things that I will start to notice if my heart valve is causing a problem? 4.2cm dilated aortic root Hi dr. In addition to the European guidelines, there is also an American set of guidelines published in the Proceedings of the 36th Bethesda Conference. I applaud your efforts to search out information to help you decide on a course of action. 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. Individuals with BAV can develop progressive narrowing or obstruction of the valve, leaking of the valve, and . I do think that aspects of the martial arts are strength-related. I am now in no mans land of not needing immediate surgery (per the pressure number in left ventricle) and not being able to run more than 30 min. Periodic re-evaluation with echocardiogram and/or CT scanning is used for most patients in this circumstance. On Monday the 13th, I had my annual echo. Miley Cyrus - Singer & Actress - Tachycardia. At the age of 12, she had a procedure to widen her valve as her heart condition continued to have an impact. Several contemporary elite triathletes have BAV and Ive written about their stories in: Examples from other sports would include Arnold Schwarzenegger, among others. 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. 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. A CT scan made the diagnosis. Outcomes in Adults With Bicuspid Aortic Valves - JAMA I can tell my story. He seen our family doctor that week who confirmed the murmur. "I have heart disease, and I found out about five or four years ago, the singer, now 49, told PEOPLE in 2008. I lifted weights for many years and spent almost all my life in physically demanding jobs. A few hours after helping the woman, she began to experience chest aches, soreness in both arms, nausea and clammy skin. Also, again, no stenosis or regurgitation, 35 mm ascending aorta. Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. This also assumes that there are no other cardiac issues or medical problems to consider. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. I read most of the posts above and I didnt find people describing the decrease in performance due to the BAV. Q And A: What is a bicuspid aortic valve? - Medical Xpress Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. No thrombus, vegetation were noted I will do whatever I can to make sure my mom is comfortable and has whatever she needs, she said. So you know, this is not uncommon for heart valve surgery patients. Shes quite the athlete. I realize that appointment availability for medical specialistsin your case, the pediatric cardiologistcan be tight. 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. You already have a cardiologist looking after you. Have you considered meeting with a heart surgeon to talk about the situation? Do you think I should slow down a little bit? Since my initial post i decided to call another pediatric cardiology hospital in our state, University of Michigan Pediatric Cardiology. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. In addition, the Left ventrical has slowly increased over this same time period from 5.87 to 6.6 cm. Your sons doctors are undoubtedly experts at pediatric patients. Bicuspid Aortic Valve and Congenital Aortic Stenosis in Children His aorta is lightly enlarged. We generally limit weight-lifting (or other sports/exercise that have a high static component) for athlete patients with BAV and mild enlargement of the aorta. The worse the narrowing, the greater will be the difference in blood pressure between the arms and the legs. This is thought to occur at a rate of about 0.1% per year in adults. The aortic valve is between the left lower heart chamber and the body's main artery, called the aorta. . Also is it possible to never need surgery to replace the valve and that the AR stays stable, or even goes away ? 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. Thanks.