In Jan 2016 My son was seen by the cardiologist and had some changes on his echo and the cardiologist said hey had mild progression of the aortic regurgitation( moderate to severe) with preserved LV function. Its a hard thing to describe to my cardiologist that my legs and HR are not cooperating when the pace picks up. Bicuspid aortic valve (BAV) is a genetic condition that causes the aortic valve to have two leaflets instead of three. My cardiologist has advised me to avoid high impact activities such as weight lifting and endurance training. Rose underwent the procedure last week, and said he would be going home to rest for a couple of weeks before returning in March. The studies on Irbesartan for Marfans(I dont have Marfans) are showing some positive outcomes; and. No stenosis, no calcification. It is believed that Schwarzenegger had a bicuspid aortic valve which led to a Ross Procedure operation performed in 1997. Arnold Schwarzenegger was born with a bicuspid aortic valve, in which the aortic valve has only two leaflets, instead of the typical three. A cadaver if valve is then used to replace his pulmonary valve. I know that there can be complication with Dacron graft or even aorta aneurysm building up but Ill stay on positive side since I have no tissue disorder and its highly unlikely that with properly working aortic valve I would develop another one in that short period of time. Normal function of cardiac valves Who Has BAV? - bicuspidfoundation.com I was hoping that if the ultrasound numbers dont change much, the endurance will not decrease significantly. I would really like for people to not have to experience what I had to experience, she continued. Advice here will be based on opinion rather than accumulated evidence in large numbers of children with BAV. In 2017, there were 3,046 deaths due to rheumatic valvular heart disease and 24,811 deaths due to non-rheumatic valvular heart disease in the United States. To save nice heart the best would be doing nothing (! I agree that its somewhat surprising that more detailed information isnt available. If so, youre far from alone. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. People can live normal lives with Congenital Heart Defects. It will probably take a visit with a surgeon (who has all of the pertinent details) to outline the possibilities for you. Could I continue to train and just cut out the blood chokes? 2023 Baton Rouge Clinic. A CT scan made the diagnosis. Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. Check out Anthony DiLemmes blog, Anthonys Heart Valve Replacement Saga. If echo shows a normal size, thats probably okay. TAVR is a relTively new technology where a new heart valve, shrunk onto a catheter, can be threaded through the bloodstream (usually through a leg artery) to where your current valve sits.and then expanded inside the current valve, pushing it aside. Hi. Finally, athletes are not spared. Shes quite the athlete. Thank you,dr Creswell, Lynn. Thank you for this blog! Dietz?) Anyway, I just wanted to say I found this article particularly informative. Today, echocardiography (ultrasound) for screening or diagnostic purposes for some other heart problem is the most common way that BAV is detected. I dont know what to do .. There have been reports of lingering effects (decreased function of the left or right ventricles) for several days after marathon runs. The HAART 200 is an innovative device that helps in the repair of BAV, allowing patients to avoid aortic valve replacement. Is this true that you wont be symptomatic with only mild AR? While it was anticipated that a minimally invasive, transcather device would be used during the procedure, a surgical valve was ultimately used during an open-heart procedure using a median sternotomy. Search Heart Hospitals I probably get more inquiries from athletes with bicuspid aortic valve (BAV) than any other single heart problem. I know it can be frustrating when you get conflicting opinions regarding the safety of exercise. I can not be on anticoagulant medications on the fire department. 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. Its a lot harder in the UK to see your cardiologist so you cant get the answers quickly. Bicuspid aortic valve with Marfan and other HTAD when the ascending aorta is dilated >45 mm. 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. Your responses mean a lot to myself and no doubt others on this forum. In the process of how I had the slow waltz with MG UNTIL DIAGnosed, will be ready in 3 weeks. She said not until it gets to 5cm. Can you clarify what may not be true please? 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. That post is a starting point for todays discussion. Im 32 years old and back in 09 I discovered I have a BAV. John Ritter - Actor - passed away due to undiagnosed CHD at age 55. I am riding my 3 rd anual Belgian Waffle Ride today. Robin Williams - Aortic Valve Replacement & Mitral Valve Repair. My sinus of valsalva is at 4.8 and my BAV is functional (discrete regurgitation). In addition to running, I also perform moderate to high intensity resistance (weight) training 5-6 times per week. Routine endocarditis prophylaxis is . The echo in Jan asc aorta Diam 4.2 cm z-score 6.4. May 11, 2010 -- Barbara Walters said on Monday that her upcoming heart surgery, a procedure known as an aortic valve replacement, will hopefully correct a problem of which . Here are some celebrities that experienced severe heart valve defects and had to have either heart valve replacement and heart valve repair surgery. Celebrities With Heart Disease - Celebrity Heart Health Survivors Regards I appreciate your response, thank you for taking the time to write me back. Im guessing that my muscles are building up again and since everything was messed up, especially on left side, maybe some scar tissue or damaged nerves are coming up. Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. My Dr is almost certain that these symptoms are caused by issues that are not cardiac related, and that with at the stage my BAVD is at, it would not produce symptoms. Bicuspid valves are quite common (1-2 percent of the population). This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . Something they suspect is also from birth but never previously picked up. 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. looking forward for healthy life without surgery any possibilities??? Bicuspid Aortic Valve Symptoms and Treatment | Baptist Health Weight-lifting is only one example, but others would include golf, bowling, shooting, etc. 2) He can lead a normal life & can continue his training with regular echocardiography control (once in a year). My question is: is it okay for me to participate in weight lifting with BAV? Bicuspid Aortic Valve - Medscape I am 6ft 3 . This visit we were told it could be a few years before anything needs to be done. Thanks so much for all this info! I am 31 years old and had my BAV repaired at The Cleveland Clinic in 1999 when I was 15. The video is just 1 min 42 sec long. Sometimes my cardiologist says there is minimal change and he thinks my aorta had slightly enlarged by 1-2mm. Only two cusps, commissures and sinuses are seen in the less common "pure" bicuspid aortic valve subtype. Who Qualifies for TAVR | Eligibility and Treatment Guidelines A week after he made the varsity team as a freshman he was told by the doctor he couldnt play. As youve mentioned, sometimes it can be useful to visit a cardiologist who has an interest in athletes and their heart problems. Frankly Im worrying quite a bit about thisand I feel like its causing additional chest pain and shoulder pain. To no surprise, people are worried about me running tomorrow. I had a Bentall with mechanical valve done in Feb 2017. No enlargement of aorta or any other problems. Please help me . mod-severe regurgitation What should I do ? Some good points there, Craig. 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? The problem is I have developed an aneurysm on my ascending aorta of 44mm. He would be devastated to never be able to play again. I am considered elite in my age division. And now my aortic root is 42 mm. Thanks for sharing. He isnt interested in anything else. Thank you for the follow-up! Key points about bicuspid aortic valve. As a result, the valve doesn't function perfectly. ( I was much worse though). Bicuspid Aortic Valve | Johns Hopkins Medicine Dr. Larry, very helpful content. Get your act together, Columbus! Im due to have an exercise tolerance test soon, but from my dealings so far Ive lost faith in the level of competence of my current cardiologist. Consensus guidelines suggest that (athlete) patients with BAV and moderate enlargement of the ascending aorta should curtail their strenuous static (eg, weight-lifting) and endurance sporting activities because of the risk of aortic rupture or dissection. Now, five months after surgery Im gradually returning to sport with 5km runs and kettlebell routine, push ups and pull ups (still feeling pressure in breast bone) no heavy lifting. I like to thank you in advance for reviewing my question and also, thank you for such a great blog. Best Valentine's Day Restaurant Specials 2023. This is thought to occur at a rate of about 0.1% per year in adults. My aortic root is 4.06 cms. I wouldnt hesitate to register your concern with your sons doctor about waiting a few weeks. Theres no reason to not be CPR certified.. My son is 12 years old. Practice Essentials. Can you direct us to ANY research on the effect of endurance sports on AVR patients? I would like to get back into it, but obviously I have been having some concerns. Bicuspid aortic valve : MedlinePlus Medical Encyclopedia Another possibility that you havent mentioned deserves some discussion with your sons doctor(s) or surgeon. Background: Transcatheter aortic valve implantation (TAVI) has achieved satisfactory outcomes in the selected patients with bicuspid aortic valve (BAV), predominately type 1 BAV (~90%). document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. And any valve substitute (with valve replacement) is clearly not as efficienteven if the substitute is better than a diseased valve. Thanks so much Bicuspid aortic valve (aka BAV) is a form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a two-leaflet (bicuspid) valve instead of the normal three-leaflet (tricuspid) valve. Keyhole just refers to the type of incision used for conventional valve replacement like you had. Again, thank you and bless you for taking the time to talk with us here! Yes, there are certainly individuals with BAV who go a lifetime without needing valve replacement or aortic surgery. Some people with bicuspid aortic valve will have symptoms in early childhood. Im am in stres ?! These techniques are most applicable to situations in which there is regurgitation, rather than stenosis, of the valve and when there is also enlargement of the aorta. Doc says no problem, but that seems to be contrary to what I see here. Body contact sports may pose some danger to athlete patients who take blood thinners. Bicuspid Aortic Valve: Role of Multiple Gene Variants in Influencing As chemist mostly works in a lab not in the field. This is the only measurement that has gone down . Tetyana. Yet Im personally aware of a good number of athletes whove returned to endurance sport after operations of various sorts for BAV,presumably after discussion with their doctors. Palace Insiders Say Prince William Is Already Furious About Prince Harrys Memoir Leaks, Prince Harry alleges Prince William attacked him over Meghan Markle in a new excerpt from, Scene Stealer: The True Lies of Elisabeth Finch, Part 1, Rupert Murdoch Knees Trump in the Balls While Hes Doubled Over Coughing Up Blood, By BG017/Bauer-Griffin/GC Images/Getty Images. Im afraid Ill end up like my Mom. From afar, its hard to know what might be responsible for your symptoms. 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). I know they really should get checked, and they will. Arnold Schwarzenegger Helped Greta Thunberg Get a Tesla, Where to Watch the Biggest 2023 Awards Contenders. Onside rations would be needed for hose with Marfans syndrome or other diseases of the aorta. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. I am big for my age . In 1997, Schwarzenegger underwent heart valve surgery to correct his heart defect. 24 HOUR GYM We were to see them in 3 months. Ive a BAV with the fusion being between my right coronary and non-coronary leaflets. Thank you very much for your thoughtful response. 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. I see my cardiologist the end of May. I continued playing hockey routinely until I was in my late twenties. My son is 15 and has grown about 4-6 inches in the last year. If labeling my fitness level I wouldnt use the term athlete, but I used to work out pretty vigorously 5 days a week until about 8 months ago (weights, medium endurance cardio, no longer distance running than 5 miles, interspersed with HIIT). This is true at rest and may be even more so during exercise. The doctor said she would see if she could talk about his case with the surgical panel but she said even if he did have surgery he couldnt have a career in sports??? Or usually lead a normal life? Im a 44 year old male. 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. which seems to suggest that he has returned successfully to the sport. But, three heart valve surgeries! On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. The various artificial valves are a little bit less efficient that the valve were born with. Contact Editor. I read most of the posts above and I didnt find people describing the decrease in performance due to the BAV. EKG and echocardiogram were done showing BAVD. Pop Medicine > Celebrity Diagnosis . In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. 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. For most athletes with only mild enlargement of the aorta and no problems with the aortic valve, there should be no activity restrictions. While i appreciate you are not my cardiologist and we`ve never met is there anything generic out there that i can look at to gain an idea. Currently, it is estimated that about 5% of those with bicuspid aortic valve disease will experience aortic dissection. If I ever need surgery to replace my root , I understand that there is an element of complexity for such surgery, but after surgery, is life expectancy for individuals assumed to be shortened at all ? Glad Ive found this website! enlarged LV = 350ml Yes, moderate aortic root dilation can remain stable. Ive yet to feel like Im back to my previous racing fitness that I once had. Thank you for your expert opinion. "I had many of them, but I thought, 'Nah.' I eat relatively well, but sometimes having those pizzas and burgers late at night I had to change that.. Echo Features of a Bicuspid Aortic Valve | 123 Sonography Barb. Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Thank you for your time. There can be issues with aches and pains even months after operation that still relate to healing. To make matters worse, I had a bout of AFIB, about 6 months ago. Bicuspid Aortic Valve How much worse does it have to get before it should be replaced? 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. I certainly know runners, cyclists, and triathletes in that circumstance who are active and doing well. I would prefer not to stop. However, is there any advantage to having them screen in their first decade of life, if they are not showing any symptoms? ANYTHING other than walking and golf? 2. Im a 33 yro female, diagnosed with BAV. Bicuspid aortic valves are more common in men, but also affect women. Celebrities With Heart Disease - Celebrity Heart Health Survivors. Kim Kardashian Doja Cat Iggy Azalea Anya Taylor-Joy Jamie Lee Curtis Natalie Portman Henry Cavill Millie Bobby Brown Tom Hiddleston Keanu Reeves. Thank you very much for the answer! 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 Reply. The guidelines were developed by an expert panel based on the scientific information available at that time: The issue has not been studied very well, but one recent study suggests that continued participation in sports for periods of up to 5 years does not change the natural history and progression of BAV. I have also had a stress test, which showed no issues at all. And what would moderate weight lifting be defined as? Arrhythmias may sometimes manifest many years after surgical repair of congenital heart defects. Dear Dr. Creswell, Therefore, in the current study, we aimed to compare procedural and 30-day outcomes after TAVI between type 0 and type 1 BAV . Valve replacement with either a tissue (bioprosthetic) valve or a mechanical valve is, by far, more common. We all appreciate it. And, if so, how did things go? Pathology. He wants to be normal. The CVTI is waging war against the leading cause of death among American men and women - heart disease. I dont believe this has been well studied. No pulmonary hypertension During the Ross Procedure, the aortic valve is removed. Please refer to this article if not: https://academic.oup.com/ejcts/article/50/3/400/2197426. 5 months ago was diagnosed with severe AR and 5 cm long aneurism (root 3.0 cm, sinusi valsave 4.3cm, ST 3.6cm, ascending aorta 3.6cm) on regular yearly checkout, with no syptoms. Great article! Replacement is much, much more common. My cardiologist tells me that I need to be monitored yearly and that I should exercise without limitation (for cardio) I have symptoms however that include chest pain and shortness of breath and palpitations. My cardiologist Said to not lift heavy weights. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. Normal LV diastolic function. After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets? 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. A normal aortic valve looks like the Mercedes logo, a circle broken up by three lines that meet in the middle. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). Sometimes patients with mechanical aortic valves report that they lose a bit of their top-end athletic performance. Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. Bethesda Conference reports), even though there is no certain link between sports and the aorta enlargement. Thanks for sharing the article about the PEARS technique. 2. Im not sure I have all the answers from afar. Many congenital heart defects cause few or no symptoms. Answers to your questions. If the conflicting opinions both come from cardiologists, you should ask them to confer with each other and arrive at some sort of consensus. 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. ", Braxton is a survivor of pericarditis, an inflammation of the sac surrounding the heart. My son is desperate to be able to play sports without any restrictions. Because it was just a cardiologist, not a sports cardiologist or physiotherapist. Bicuspid aortic valve is a type of abnormality of the aortic valve. How long does it take for the homograft to completely heal? How much exercise is too much for someone with a functional BAV? Now I wanted to start again (also due to the 8kg I accumulated in the meanwhile:( ) and I discovered that I can barely run 5K in 30 min and I generally find it very difficult to run. 1, 2 Much of the data relating to its complications derive from necropsy studies since reliable . Required fields are marked *. Diagnosed last year while looking at something else. Or is the real risk related to further deterioration of the heart in the longer term that would be picked up by 6 monthly monitoring, which may indicate the need for surgery but not an immediate risk of dying suddenly? The pitfall, though, is that our native aortic valve is itself very efficient. We go back in 3 months for another echo. Consensus guidelines suggest restricting activities in athletes with BAV and aortic diameter >4.0 cm. One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. Do you think running 40 minutes five times a week at that level of beats can increase the aorta rate of growth ? The doc states that basketball is a contact sport in her medical books and we would need to consult with another doctor to possibly get approval. This has caused a Thoracic aortic aneurysm that is 4.3 cm. Center for Bicuspid Aortic Valve Diseases | Penn Medicine I see in this blog that Dr. C noted: Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. Dear Dr. Creswell, I was shocked. The aortic root is moderately dilated (max 46mm sinus to opposite commissure but you can measure 48off axis). Hi Dr Creswell, SPORTS FIGURES/ATHLETES. Arnold Schwarzenegger's Heart Valve Surgeries (2020 Update) I am wondering if you know anything about these drugs and how they can impact aortic growth? Star Jones. I think we would expect less enlargement over time with stopping strenuous exercise. Bicuspid aortic valve (BAV) is a heart problem present at birth and the most common congenital cardiac anomaly, with an estimated incidence of 0.5 percent to percent in the general population. I had my BAV replaced in Feb. 2005 (porcine tissue) with a Dacron repair of the ascending aorta. No other issues. Are there any things I can do now to help minimize my risk? He has been restricted from playing contact sports since hey was 10. Robbie Benson - Actor/Director - Bicuspid Aortic Valve. I have been doing this for the last 5-6 years now and am hopeful it can continue. 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 . Use or viewing of any Baldwin Publishing, Inc. article signifies your understanding and agreement to the disclaimer and acceptance of these terms of use. In April of this year (2016), I discovered I had a BAV in the worst manner possible. In your experience, can patients with BAV go a lifetime without having AVR? He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. We see his pediatric cardiologist every 6 months. This can lead to stretching apart of the valve leaflets and leakage at the valve, known as regurgitation. "Weve gotten a lot closer and weve learned each other on a whole different, deeper level, she told PEOPLE in 2015. Activities are not usually restricted for athlete patients with mild aortic stenosis. This content can also be viewed on the site it originates from. I dont have any ayptoms. The valve can gradually become harder to open or leakier . 1. Any words you have for us would be greatly appreciated. The incidence of normally functioning bicuspid aortic valves is 0.6% to 0.9%.5 . Willie Moses Ive been affected by heart disease practically my whole life, she said. I had AVR 3 years and 4 months ago. Kimberly has experienced heart valve disease firsthand. If reoperation is needed in your case, this would be something to discuss. I do not have Julys echo results yet. Index to blog posts and online articles, Filed Under: Heart problems Tagged With: aorta, aortic aneurysm, arotic valve, bicuspid aortic valve, congenital heart disease, heart, heart surgery. Considering the results of my stress test and TOE, do you think it could be my heart and should I seek 2nd opinion. Well, as it happens, the Cleveland Clinic has been recently rated the top heart hospital in the nation, and the number two hospital overall. His aorta is lightly enlarged. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. I agree that your doctor(s) are in the best position to offer advice regarding safe exercise based upon your particular circumstances. To revist this article, visit My Profile, then View saved stories. Dr. Larry, I do appreciate your insightful article very much. In late March, Schwarzenegger was heavily involved in a chess tournament with his donkey Lulu. I currently run 40 -50km a week and do two 2 hour intensive yoga sessions a week. Hello dear doctor. I am a 23 year old male, have BAV with mild AR. 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. Aortic Valve: Function, Location & Anatomy - Cleveland Clinic I found a cardiologist with whom Im quite happy with. My son is a baseball player, so that is good. I have a few questions because I was instructed not to lift more than 10 lbs and that I could resume surfing in a year. Rest pulse (70 bpm|50 bpm) When the aorta is enlarged in the setting of BAV, there are a couple possibilities: the valve needs to be replacedor it doesnt: Valve repair. California Governor and movie star of films including The Terminator and The Predator, Arnold Schwarzenegger marked the 10-year anniversary of his heart surgery at USCs Health Science Campus. triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? No one loves life more than I do, read the statement. Dr. Larry, thank you very much for your blog! Questions currently remain about how long such repairs will last and whether patients might require re-operation at some point in the future. I used to do HIIT and moderate to heavy weight 5 days a week before my physical complications. I was concerned about his cough last weekend so I was assessing his lungs with my stethoscope when I heard a very pronounced diastolic murmur at his 3rd ICS. Our only tool to keep track of aortic enlargement is repeated measurements with CT or echo. Okay to wait? 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. The aortic valve prevents blood from flowing back into the left ventricle of the heart. We have got two completely different opinions from our cardiologists: