And any valve substitute (with valve replacement) is clearly not as efficienteven if the substitute is better than a diseased valve. I dont want to do any damage or compromise my homograft as the last surgery was a very difficult recovery. i.e. enlarged LV = 350ml Guidelines specifically for athletes come from the Proceedings of the 36th Bethesda Conference in 2005. While I no longer due very strenuous activities, I still play softball, golf, kayak, ski, and do play hockey every now and again. My doctor says i use losartan for decrease my blood presure. Your surgeon will be in a good position to understand the exact details of operation that might be relevant when deciding whats safe.. My Echo Stress Test is normal but when I finish obviously the pressure is higher (190-80 at the end) . 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. Hector V. Ive never heard about a mechanical aortic valve becoming loose because of high HR. I was born with a BAV and but I didnt notice performance issues until the Summer of 2016, so I brought myself to the doctor. Thank you for your time Dr.! My name became public 25 years ago this week. I like to practice MTB and running competitively in local races. I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. since the last worsening ten years ago, the situation still stable and each year I went to the doctor to have the tests, they still tell me nothing has been changed since. what recommend me? 2k erg test. Lack of breath? 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. And lastly, the degree of healing in the remaining (unoperated) aorta probably has a big impact on the potential risk. My son was just told he made the varsity basketball team as a freshman. Diagnosed at 5 with BAV, checked yearly, and okayed to play soccer. 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. with valve area of 1.4 cm2 and aorta of 4.1 cms My cardiologist has told me that, based on how my heart sounds, he doesnt think hell ever have to operate on me. eventually was told everything was ok. Assuming that 2% of the US population has bicuspid aortic valve disease, that is 6,278,281 people. From the outside, these people look healthy, and some are, while others are not. Easy bicycling might work, but I suspect that running wont be workable with that cap. Diagnosed last year while looking at something else. The notion is to reduce the number of cycles of heart beat x high blood pressure. After an MRI, Ive been diagnosed with BAV and mild aortic coarctation. There are four valves of the heart, which are divided into two categories: Atrioventricular valves: The tricuspid valve and mitral (bicuspid) valve. I would defer to Dr. Dietz since youve already contacted him. I hadnt heard about the technique previously. What have I observed and learned in the quarter century since? 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. Now, fully healed thanks to two stents in her arteries, Lucci is spreading the word. Also twice a week I try to do 40-minute workouts like planks, pushups and so on (with my bodyweight). A cadaver if valve is then used to replace his pulmonary valve. "Heart disease is the number one killer of all Americans, the number one killer of African-Americans and the number one killer of women, so I shouldve been put on notice since Im three-for-three. , Bicuspid Aortic Valve Disease, Acquired Valve Disease. Also is it possible to never need surgery to replace the valve and that the AR stays stable, or even goes away ? In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. Yesterday, for example, I spoke with a 71-year old patient who just had aortic valve replacement surgery due to this . 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. transcatheter aortic valve replacement (TAVR), Mick Jagger's Heart Valve Surgery: Top 5 Facts. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. Bicuspid aortic valve (BAV) and congenital aortic stenosis are two types of heart defects that may be present at birth. 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. Is this a possible explanation? Bicuspid Aortic Valve: Symptoms, Diagnosis & Treatment, Biological Tissue Valves: Pig, Cow, Horse & Human, The Patient's Guide To Heart Valve Surgery. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). It can also lead to aortic stenosis , and is more . The doctor looked at the results and told me to limit physical activity (running), because it can lead to heart failure in future. Sbp. Would this constitute as too much in your opinion ? New guidelines from the American College of Cardiology (ACC) were published just this week. I was running 9 to 10 minute miles. "Until then, stay close.. 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. Almost half of BAV subjects develop different degrees of valvular dysfunction during their lifetime. At my last evaluation, my aorta measured between 4.3-4.5 cm, depending on where the measurement was taken, and the regergitation was classified in the moderate range. Regarding the PEARS, the main concern is about the possibility that the aorta dissects even in a controlled measure (lets say 4.5cm). Several contemporary elite triathletes have BAV and Ive written about their stories in: Examples from other sports would include Arnold Schwarzenegger, among others. Okay to wait? Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. Yes, there are certainly individuals with BAV who go a lifetime without needing valve replacement or aortic surgery. Hi Larry, thanks for doing this website, I wish there were more like it. 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. Dear Dr. Creswell, Thank you for your expert opinion. Average STS score was 1.7%. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. Kinda like a marathon but it will take me at least 9 hours. Im not a nurse or anyone who can help in any real way, she told PEOPLE, fighting back tears. Common symptoms include chest pain, shortness of breath, dizziness and fainting. The procedure has the potential to bring the aorta to 4.3/4.4 and avoid further enlargement. And during the years, this remained pretty stable. When you start seeing changes with regurgitation does it progress quickly? Barb. The issues related to repeat aortic valve surgery, with or without replacement of the aorta, are complicated. We just saw them in January. He just turned 15 he is 511 203 lbs and has a heart of gold. 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. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. after surgery and was playing football again by September. His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. Youve got the right idea, though. According to reports (and my new cardiologist), this congenital variation . I had a ventricle septum defect patched up shortly after birth with no further follow up and a full recovery. Holding breath during lifts valsalva). This year (her junior year) her Cardio doc is saying that she cant in good conscious clear her for basketball (the sport my daughter LOVES). 1. Im not familiar with employment eligibility issues with BAV, even in this country. When there is narrowing (stenosis) or leakage (regurgitation) of the aortic valve, the heart must do extra work. It has a male predominance and often occurs in multiple members of the same family, suggesting that it may have an autosomal dominant inheritance, perhaps with variable penetrance. Semilunar valves: The pulmonary valve and aortic valve. 2. A total of 25,556 newborns (51% male; mean age, 12 days) underwent echocardiography. 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. And, of course, aortic stenosis can affect ones native aortic valve or a prosthetic valve substitute. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. I wish you both all the best. Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. Is the biggest risk (from numbness) a over-calcified valve which would cause lack of blood flow? 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. Consensus guidelines from the Proceedings of the 36th Bethesda Conference recommend: The first recommendation does not include the endurance sports. Nwankwo Kanu (@papilokanu), the Olympic Gold Medalist (Soccer) suffered from Aortic Valve Defect. He/she can talk with you about the generalities of operation in your circumstance. Pop Medicine > Celebrity Diagnosis . Also, due to a bout of DVT and elevated d-dimers Im on Warfarin for life. This is an unfortunate situation for the athlete patient because the consensus guidelines do not yet recommend operation, yet advise against strenuous sports activities. I had an echo because of a scuba diving accident and was discovered to have a BAV (no PFO). Thank you for the follow-up! 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 . I inderstand that my resistance training will likely be severely curtailed from this point forward, but severe restrictions on my endurance training will be a very difficult pill to swallow. I have regular checks, 12 to 18 months, and until about 3 years ago was told that it was hard to tell that Id had a replacement valve, it now shows slight stiffening. There have been reports of lingering effects (decreased function of the left or right ventricles) for several days after marathon runs. This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. For example, are there data that shows what happens to aortic diameters once sports have been stopped? Specifically, Im wondering about inversions like forearm stand, head stand, and hand stand. Search for heart hospitals that specialize in heart valve treatment. Replacement? I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. 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 found a cardiologist with whom Im quite happy with. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. Males are affected 3:1 compared to females. In late March, Schwarzenegger was heavily involved in a chess tournament with his donkey Lulu. No pulmonary hypertension I eat relatively well, but sometimes having those pizzas and burgers late at night I had to change that.. However, this is not always the case. Parenthetically, it may be time for an update. At the USC Cardiovascular Thoracic Institute, we are dedicated to improving the statistics concerning cardiovascular and thoracic disease such as those once faced by the governor, said Starnes, who also serves as executive director of the Institute. Is this the case? She advised us we should start to consider surgery but would follow up with us again in 3 months. Although bicuspid . It was reported on April 5 that the 75-year-old Jagger underwent successful transcatheter aortic valve replacement (TAVR) at an undisclosed hospital in New . There are several variations of this procedure that are applicable in specific situations. 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? Having a congenital heart defect means you are born with a problem with the hearts structure. "Schwarzenegger's pulmonic valve was successfully replaced.". Currently complete in 5-a-side football and have done for life. Surgery. On March 30, 2018, we learned that Arnold Schwarzengger required a second heart surgery. I dont know why this formed as I have had the problem valve replaced many years ago. The singer co-founded the Womens Heart Alliance, which works to raise awareness and funds research to fight womens heart disease. Everyones symptoms are different but I felt compelled to share mine. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. I would pose these questions to your doctor(s) since they are most familiar with the details of your situation. Keep us posted! 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). No other issues. Advertisement. Therefore, in the current study, we aimed to compare procedural and 30-day outcomes after TAVI between type 0 and type 1 BAV . Who Qualifies for TAVR. I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. Nonetheless, I think theres considerable confusion about this condition, in terms of diagnosis, implications for the athlete, and its treatment. I started experiencing palpitations last year along with several instances of light-headedness. which seems to suggest that he has returned successfully to the sport. My son is 16 years old and his story is very similar to many I read on your blog. People can live normal lives with Congenital Heart Defects. In 1997, Schwarzenegger underwent heart valve surgery to correct his heart defect. 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. My heart seems to heal, so that speaks well for my future.. That is someones life.. It may cope adequately for a few years if the person leads a sedentary life, but the longer crucial surgery is delayed, the more damage there will be to . 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? I have had scans and echos for as long as I can remember and have never been on medication nor has this condition stopped me from doing anything I have wanted. Get your act together, Columbus! Thank you for your assistance in this matter. Most people require treatment once symptoms develop. I am a 36 yo male who was first diagnosed with BAV at the age of 17. 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. Many thanks again for answering this. Thats about as specific as he got. Im 33 from UK and have known about my BAV since I was around 18. Im paranoid to exercise too much for fear that I will do damage to the valve. Thanks very much for this Dr, it is really helpful to get someone elses opinion on the subject and Ill definitely raise those points with my cardiologist next time we meet. Many congenital heart defects cause few or no symptoms. And, if so, how did things go? Sometimes patients with mechanical aortic valves report that they lose a bit of their top-end athletic performance. With the blood thinning needed for a mechanical valve, serious bleeding may occur with injuries. The more common form of bicuspid aortic valve occurs in a valve with three cusps with . In the process of how I had the slow waltz with MG UNTIL DIAGnosed, will be ready in 3 weeks. Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. Thats the main reason for choosing a tissue valve in my case. The incidence of normally functioning bicuspid aortic valves is 0.6% to 0.9%.5 . 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. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. Thank you for what you do and for your responsiveness. I dont believe this has been well studied. My last CT scan in November showed a change from 4.3 (May) to 4.5 (November) however I was only given these results yesterday. Symptoms of bicuspid aortic valve disease most commonly develop in middle age in people with a history of a childhood heart murmur. Keyhole just refers to the type of incision used for conventional valve replacement like you had. Is it possible that the valve will get loose? Im a 30 year old male who is currently living in Asia with family. 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. A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. Context Bicuspid aortic valve is the most common congenital cardiac anomaly in the adult population. In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. Thank you to every doc and nurse on my team.". On April 16, 1997, Arnold Schwarzenegger underwent elective heart surgery to replace a defective, congenital aortic heart valve. Bicuspid aortic valve (BAV) disease does not usually cause symptoms. Ordinarily, race walking is considered to be in the same category of activity as long-distance running. After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets? Thanks in advance. My cardiologist has advised that while marathon running is out, shorter runs (up to 6-8 miles) and pilates are both fine for now. 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. I have 4 children and a great wife. One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. To me, cardiologists are not sports people and air on being absolutely over cautious. 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. Weight-lifting is only one example, but others would include golf, bowling, shooting, etc. His only complaint or change is shortness of breath with stairs. The congenital bicuspid aortic valve (BAV) condition is a valvulo-aortopathy with substantial heterogeneity in its clinical expressions, associated disorders, complications, and prognosis. You could probably settle on a plan for return to exercise with your surgeon and cardiologist. I found myself in emergency surgery 12 months ago with 50% leakage, an enlarged heart and an ejection fraction of 30. Youre right, though. Your sons cardiologist would seem to be in the best position to offer specific advice. Maybe you can help me with some questions. I would like to thank you very much for providing me with your thoughts. From afar, I dont have much to add. 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. There is very little scientific evidence to guide us here. Ive yet to feel like Im back to my previous racing fitness that I once had. Interestingly, bicuspid valves are one of the most common forms of heart valve disease. I have found out I have a BAV last year. The only prudent course is to have periodic follow-up imaging to keep track of size/growth. lifting a max bench of 150 lbs Barbara Walters - Aortic Valve Replacement. It makes the heart work harder than it should. I dont have any ayptoms. He wants to be normal. Film star, former California governor, and seven time winner of the Mr. Olympia title Arnold Schwarzenegger published positive images to his social media platforms on Friday as he recovered from heart surgery. Hey is a frustrated guy. Enjoy! Bobbie. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. Or usually lead a normal life? Thanks for the infoI really appreciate what you,have to say. 100 Black-Owned . After an echo and an MRI with and without contrast, I found out that I have a BAV with mild aortic and pulmonic valve regurgitation. The increased stroke volume and cardiac output may cause . While the defective valve may be easy to see, the defect also causes changes in the tissues of the aorta and the heart. I am a 23 year old male, have BAV with mild AR. Bicuspid Aortic Valve Now I take brisk walks and run on the treadmill only occasionally. Thanks for sharing. Is it like keyhole surgery? Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. "Women are the natural caregivers; we take care of everyone else under the sun," she says. At this appointment she advised that there has been some progression in his regurgitation and she did a stress test on him which did not show any concerns and hey was a ble to do it for almost 12 minutes. Look forward to your reply and thanks for your time. To quickly review, individuals with BAV have an aortic valve with 2 unequalinstead of the usual 3 equal sizedleaflets. My AVG HR on a daily basis is between 61-64 (that includes a workout where it exceeds 150 at times), I have no intentions of racing this marathon, simply crossing the FINISH line, and my heart rate will not exceed 150 I will walk when/if necessary. 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. I have 6 years to go to retirement at the very least. The false lumen extending into the abdominal aorta was left since the point of origin in the ascending aorta was repaired. Or, is it something that can wait until they get sports physicals in their teens? And he never had any symptoms and played competitive soccer since he was 6. 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. BAVD is a malformation of the aortic valve present at birth that leaves you with two flaps instead of three, tripping up blood flow to the aorta. All aorta is normal, valvula normal funkcion only sinus valsava 35-37mm. "Were saying to put the focus back on you and make a date with your heart.". I have a call in to his doctor but what do you think? If reoperation is needed in your case, this would be something to discuss. I have just one thing bothering me, and that is healing of tissue surrounding heart and also chest muscles, nerves and so on. Push for earlier date? I am healthy, strong, and active. The CVTI was created under the leadership of Dr. Vaughn Starnes, chair of the Department of Cardiothoracic Surgery and surgeon-in-chief at the Keck Medicine of USC. However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. As chemist mostly works in a lab not in the field. is my lack of top end performance indicative of someone with BAV & aortic coarctation? I have a 15 year old son with a BAV, Aortic stenosis, Noderate regurgitation and dilatation of his ascending aorta. I currently lift reasonably heavy weights in the 8-12 rep range, including body weight excercises such as pull ups and push ups. Your responses mean a lot to myself and no doubt others on this forum. 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. He has stenosis and moderate regurgitation. Do you recommend any particular diet, exercise, vitamins,etc.? 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 was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I am big for my age . My cardiologist said that sometimes it remains stable and never grows anymore. The use of a less invasive transcatheter therapy in this . 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. No one loves life more than I do, read the statement. If a large enough valve is implanted, there may be no noticeable impact on the ability of the heart to do extra work that comes with running (or any exercise). For these individuals, provided there is no other relevant heart disease, it may be appropriate to have follow-up echocardiogram and/or CT scanning every 2 years. CT or MRI may be more accurate. Others won't have symptoms until adulthood, if ever. Hi Larry The mechanical valve conduit replaces the valve with a mechanical valve and the aorta with a Dacron fabric tube. Im less certain about how BAV, coarctation, and history of VSD repair might impact ones current top-end performance. I just need to know if these sports are a possibility (im pretty sure football is a no given its contact nature). Do you think the jiu-jitsu (e.g. The actress, 44, found out she had a leaky valve in 2002. 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. Bicuspid valve stenosis treatment involves surgery to replace the valve. I am 26 yera old , I have aortic aneurisem. Ive done the Philly a Marathon a coup,e times and know that its a terrific event. ), Your email address will not be published. No LA, RA, RV, chamber dilation I lifted weights for many years and spent almost all my life in physically demanding jobs. 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.