In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. Over time, there will be some patients who develop problems with the prosthetic heart valve or enlargement of some portion of the aorta (that hasnt already been replaced) that requires operation. Easy bicycling might work, but I suspect that running wont be workable with that cap. And what would moderate weight lifting be defined as? For many patients, I recommend no heavy lifting (>10 pounds) for the first month after conventional heart surgery. My cardiologist has advised me to avoid high impact activities such as weight lifting and endurance training. Get on with it. I was diagnosed with BAV about four years ago now by fluke whilst looking into my high blood pressure (I was only 24 at the time so I underwent a lot of testing due to my age and HBP the conclusion was it is hereditary, with many members of my family with HBP). In addition, the Left ventrical has slowly increased over this same time period from 5.87 to 6.6 cm. Sadly, we dont have a crystal ball, though to know what the future holds for any particular individual. This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. Good to hear that youre doing well. I certainly know of athletes who return to all forms of endurance sport as well as weight-lifting after operations like yours. Replacement is much, much more common. "I Googled 'womens' heart attack symptoms,' " her blog post continued. 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Perhaps that will provide so e reassurance. It might be wise to have discussion with your doctor about the particular activities youre concerned about. Im am in stres ?! You didnt mention your age, but obviously youd hope that whatever operation is performed.lasts a lifetime. 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. Should I increase amount of weight? Thanks for sharing the article about the PEARS technique. Answers to your questions. Valve replacement with either a tissue (bioprosthetic) valve or a mechanical valve is, by far, more common. 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. As chemist mostly works in a lab not in the field. Latifah has taken on her mom's caregiving duties, along with relatives and a nurse, whenever she is on the east coast. Reply. Jeff. But Bob, you confirm that it does for you; and unfortunately I see same for me although 25 years younger. So my question: does there appear to be any performance advantage of tissue valves over mechanical or does the fact that Im on the anticoagulant anyway make the mechanical valve sort of a no brainer choice? I dont know why this formed as I have had the problem valve replaced many years ago. Lastly, a human donor valve was inserted into the pulmonary valve position. Willie Moses There are many surgical options depending upon the particular circumstances. My surgeon basically said, Lets get you back to living your life. Cardiologists always say take it easy. Most people require treatment once symptoms develop. That means it is a congenital heart defect. We just saw them in January. after surgery and was playing football again by September. Bicuspid aortic valve refers to a spectrum of deformed aortic valves with two functional leaflets or cusps which are often unequal in size. No LA, RA, RV, chamber dilation Bicuspid Aortic Valve with trivial AR. I have severe aortic stenosis with no signs or symptoms. 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. Adam has been featured by the American Heart Association and Medical News Today. Thats probably what the doctors are watching for. 6 weeks later Im still experiencing symptoms that (in the back of my mind) have me thinking about the BV issue. Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. In short, I consider myself to be a high level athlete. It is very informative. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. Frankly Im worrying quite a bit about thisand I feel like its causing additional chest pain and shoulder pain. Aortic valve repair is sometimes possible. Benefits: no blood thinning (with attendant risks) needed. I have recently found out that I have aortic regurgitation will soon be needing surgery. The confusing thing I hear is some cardiologists telling BAV people not to life over x lbs. As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. diagnosed wid BAV AND AS WITH AR What is a TAVR? Glad to hear that youre recovering, Zdenko. You might keep in mind that trans-catheter aortic valve replacement (TAVR) can be used to re-replace the aortic valve. The free weights are about 10kg and Im not doing any really heavy weights. Does the (unreplaced) aorta enlarge over time? If Im trying to do 10 it will be harder to get those 2 up but it wasnt that hard before. The fusion (sticking together) of the valve leaflets causes abnormal valve opening and closing. with an efficiency of 69%, I have an appointment with a specilaist next week and am just wanting some, even if vague, answers. Im 53. what would your advice be for training & competing? Throughout the years he has played football and basketball. In the process of how I had the slow waltz with MG UNTIL DIAGnosed, will be ready in 3 weeks. There are a multitude of patient-specific circumstances that must be considered when deciding if and when operation is needed. Also suggested taking low dose of beta-blockers although I have been told the effectiveness has not been proven. This award-winning website has helped over 10 million people fight heart valve disease. Barb. Thanks for the article! 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? In some cases, the aortic valve can be repaired and the enlarged aorta can be replaced with a Dacron tube. I have been advised not to run any more marathons or half-marathons, but that I can still compete at up to 10km races. Required fields are marked *. I had a good childhood being very active in sports and physical activity, I had just had to watch out for contact due to warfarin. I suspect it had been leaking for a long time, as I felt no different; however, my recovery from long runs took longer than in the past (old age?). Every 6 months it is getting larger. We have decided to wait and watch. No stenosis or regurgitation, aorta 27 mm at the time. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. He has mild AS and AR and is otherwise asymptomatic. In March 2018 he underwent emergency surgery to have this replacement valve replaced. The flaps are called cusps. 7373 Perkins Rd
I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. Aortic regurgitation (also called aortic insufficiency), which is a leaky valve. Although bicuspid aortic valve is typically asymp tomatic at fi rst, it is commonly associ-ated with progressive valvulopathy and tho-racic aortic disease. I am a cycling Masters racer (Cat 2) for last 25 years . Join Vanity Fair to receive full access to VF.com and the complete online archive now. 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. Or its the result of the cumulative effect of the aortic and mitral valve leakage? Consult your doctor to see if there are any restrictions that would be specific to your case. This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . All rights reserved. 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). Notify me of follow-up comments by email. 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. Apparently I also have a mildly enlarged IVC as well as mildly enlarged left and right atria. Many endurance athletes are able to return to their sports after operation for BAV. Theo Wargo/Getty. "I had been doing some work around the house working with a heavy ladder, he told PEOPLE of his activity in the days leading up to his heart attack. We saw cardio in April again and my sons symptoms are the same and no progression on the aortic regurgitation. And any valve substitute (with valve replacement) is clearly not as efficienteven if the substitute is better than a diseased valve. When Ive had patients in your situation, Ive usually recommended getting the screening when its CONVENIENT. I was training for a marathon when I was 62 years old and diagnosed with BAV with severe regurgitation. I dont know anything about crossfit but I see his times are average on that page. I have no proof this may be causing my less than stellar performance or if perhaps I should have more patience. 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. I have 4 children and a great wife. Yes, there are certainly patients with BAV who never need operation. Thanks for sharing. It seems to be a very interesting option for those who have aortic dilatation due to Marfan or BAV (which is my case). Bicuspid aortic valve is associated with abnormalities in the coronary artery anatomy in about 2% of patients, including anomalous origins of the coronary arteries and upwardly displaced coronary ostia. After that, most patients can gradually return to activities that put stress on the sternum and upper extremities. I wish you both all the best. 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. His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. Bicuspid valves are quite common (1-2 percent of the population). Diagnosed last year while looking at something else. What a great resource! Cardiac outcomes in a contemporary population of adults with bicuspid aortic valve have not been systematically determined.Objective To determine the frequency and predictors of cardiac outcomes in a. I have completed two marathons. Thank you very much for the answer! We dont have a crystal ball, though. 2. Almost 15 years ago skilled surgeons replaced my aorta valve with a new replacement valve. The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. Anything you can offer up here would be very much appreciated. Thanks for sharing your sons story. Aortic valve regurgitation: Blood leaks back into your left ventricle instead of only flowing into your aorta. The Ross procedure borrows your sons pulmonary valve and uses it to replace his aortic valve and aorta. Rather than just sit there and do nothing about how much I missed [my mother], I put all of that pain, sorrow and longing for my mother into helping educate and make people aware. I get sporatic tingling in my left hand and footand every so often in my left cheek bone. Our only tool to keep track of aortic enlargement is repeated measurements with CT or echo. Oh, plenty. Last few weeks Im getting chest pain on left side (very rarely on right side) while running and doing push ups. 100 Black-Owned . She said not until it gets to 5cm. First, youre not alone! He was very talented at football. Zdenko . Im not familiar with employment eligibility issues with BAV, even in this country. Doctors at the Frankel Cardiovascular Center's Comprehensive Aortic Program have . The pitfall, though, is that our native aortic valve is itself very efficient. Dwayne E. Russell Hi again Dr. Creswell, To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. I do not do any kind of sport and I want to have healthy life at make sure my situation not getting worse and I weight 90 kg. I agree that its somewhat surprising that more detailed information isnt available. Moreover, there is a myriad of operations that such patients may have had, each with its on set of considerations. Before 2 years my aorta was 37mm . Hi, Further to this most recent discussion point I was advised that isometric exercises, such as planks and other pilates type activities, as I understand them, are perfectly safe with BAV. Weve known the risks and my daughter has done well to avoid scrapping for the ball etc. I would encourage you to have further discussion with your doctor(s) about EXACTLY what forms of exercise are safe. thanks for sharing all this interesting info. The congenital bicuspid aortic valve (BAV) condition is a valvulo-aortopathy with substantial heterogeneity in its clinical expressions, associated disorders, complications, and prognosis. They dont know they have it [It] leaks blood. I had AVR 3 years and 4 months ago. My cardiologist has advised that while marathon running is out, shorter runs (up to 6-8 miles) and pilates are both fine for now. My daughter has played two years of varsity basketball already. I did cardio training 3 times a week and weight training twice a week for 60 years. I am now down to seeing my doctors every 3 years or so and have been doing very well. The doctor said it wasnt serious, but that I should keep watch on it every year. That post is a starting point for todays discussion. I think hes amazed by what I have described for my workouts of 65+ mile rides several times a week. Normal LV diastolic function. He is very athletic. Is that far fetched? The echo in Jan asc aorta Diam 4.2 cm z-score 6.4. My 28, got a BAV with mild stenosis and a aortic root measuring 40mm. If reoperation is needed in your case, this would be something to discuss. Do you recommend any particular diet, exercise, vitamins,etc.? This can be very frustrating to athletes who are used to being more active. My son is a baseball player, so that is good. Is it possible that the valve will get loose? His exercise stress test on 8/5/16 was fine. Jeffrey Howell didn't know he was born with a bicuspid aortic valve until December 2015. During the Ross Procedure, the aortic valve is removed. I know I will need it replaced. I am also in grey zone waiting for surgery. I think its reasonable to think of things this way. Jeff/Doc, This was during a 12 week intense training block where my resting heart rate got as low as 42 bpm. Thanks! Ive not found any programs for evaluating repaired athletes unless something exist with a physiologist research lab. His doctor said his heart look very healthy and no other issues. During pregnancy. Guidelines suggest that athletes with BAV, normal size aorta, and no more than mild aortic regurgitation or stenosis can participate in all sports, without restriction.provided that they do not have an inherited connective tissue disorder like Marfanss syndrome. Youll need to rely on your doctors for advice about your condition. 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 Heart Association to raise awareness. Questions currently remain about how long such repairs will last and whether patients might require re-operation at some point in the future. no tiredness, no dizziness, etc. I have question about your opinion about aortic valve regurgitation (no BAV) Could I continue to train and just cut out the blood chokes? The ST junction and ascending aorta are mildly dilated max 35mm. 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). They are located between the atria and corresponding ventricle. Thank you for the blog that addresses the athletes point of view, and feelings. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . Again, this is a topic that is not yet well-researched. The doc says the big risk is due to the blood thinners. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. OPTIMUM HEALTH, INC Im just going to do my very best to stay the course and have annual echoes to track my valve. We have got two completely different opinions from our cardiologists: Now Id like to know your opinion about physical performance, before and after. These operations can sometimes enjoy the benefits of each of the operations you mentioned.and avoid done of the down sides. What signs should I look out for? Flaps of tissue on the valve open and close with each heartbeat. Make no mistake, though. The incidence of normally functioning bicuspid aortic valves is 0.6% to 0.9%.5 . As Schwarzenegger previously had two cardiac procedures, it is possible that Arnold may have received aTAVR using a Valve-in-Valve approach to replace his failing aortic tissue valve that was implanted in 1997. Congrats! (Have you heard of the studies by Dr. Mild/moderate regurgitation. She was originally under the impression she felt the way she did simply because she was exhausted. Athletes in this circumstance should collect opinions from their doctor(s) and make very careful considerations before returning to exercise. 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. Aortic dissection, a tear in the wall of the aorta. We use surveillance (you mention every 6 months) because usually problems with progressive enlargement of the aorta or with the valve itself can be picked up before there is any lasting harm. Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. 2012; 109:1632-1636. I have also been advised that running intervals at over 80% max heart rate would not be sensible. 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. If echo shows a normal size, thats probably okay. What should I do ? After his procedure, Arnold posted the picture above with the following statement, "Thanks to the team at Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery. The surgery was a full success, and the valve is closing really well now. It also featured an extended chat with Schwarzenegger's old boss James Cameron, and, despite an attempt, not even the mighty Arnold could pry any Avatar 2 secrets loose. 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. "The 1997 heart valve replacement was never meant to be permanent," stated Daniel Ketchell, a spokesman for Arnold. 1. 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. In fact, like most people, the 25-year-old had never heard the term before. Thank you very much for your thoughtful response. Aortic stenosis and bicuspid aortic valve (BAV) This can cause the valve to malfunction and prevent blood from flowing correctly from the . At approximately three months I became very ill and was diagnosed with prosthetic valve endocarditis. 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. Anyway, it has slowed to 1 mm per year, and, via email, Dr. Dietz has suggested we may consider a switch to 300 mg Libersartan? I had AVR exactly 1 year ago to the date. I am 18 now, and I am interested in weight lifting. 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. For patients with bioprosthetic valves after heart valve surgery, the valve itself is not usually affected by weight-lifting activities. Aortic enlargement in patients whove had valve replacement for BAV can be a vexing problem. Have you considered meeting with a heart surgeon to talk about the situation? 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. "Weve gotten a lot closer and weve learned each other on a whole different, deeper level, she told PEOPLE in 2015. 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. Medical therapy may be useful to slow or halt the progression of aortic valve disease and aortic enlargement by reducing the blood pressure and the blood pressure across the aortic valve.