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. You would never know meeting these celebrities that they had a CHD. 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. We are trying to work out a way for her to continue to play. Hi dr. This is the only measurement that has gone down . Before that, I had never seen a cardiologist ever. Aorta diameter (34 mm|34 mm); I have just one thing bothering me, and that is healing of tissue surrounding heart and also chest muscles, nerves and so on. I am young with many years ahead, I dont want to accept this just yet when I know theyre is possibilty of repair. I did cardio training 3 times a week and weight training twice a week for 60 years. After 5 years of amateur competitive rowing, I had no problems keeping up with my peers whilst training at lower intensities. 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. It functions as a one-way valve, opening and closing with each heartbeat, which keeps the blood flowing in the correct direction. Is that so, or can it be measured by the echocardiogram as well? Anything you can offer up here would be very much appreciated. One young man's complications from a bicuspid aortic valve were life-threatening, but perseverance and expert care helped him make it through. However, many people will develop complications from their BAV and may need surgery in their lifetimeeither to repair or replace the aortic valve, the thoracic aorta or both. A repaired valve may not be as efficient as the native, healthy valve. However, is there any advantage to having them screen in their first decade of life, if they are not showing any symptoms? http://games.crossfit.com/athlete/39565 document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Dr. Larry Creswell on athletes and heart health. Thoughts. She partnered with the American Heart Association to encourage others to get CPR training that could potentially be life-saving. 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. Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? 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. 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 . I was having chest pain and flew to Thailand to see what the issues were and they found I had GERD and Esophagitis. Im a 29yo CrossFit addicted man who just found out I have BAV while applying for the defence force here in Australia. Mild/moderate regurgitation. Stories of Bicuspid Aortic Valve. I wouldnt be happy just running I want to be the best that I can be at it. I do not have Julys echo results yet. On March 30, 2018, we learned that Arnold Schwarzengger required a second heart surgery. To help correct the regurgitation, the cusps of the patients valve leaflets can be tailored, with the valve leaflets left in place. 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. I have wife and two small boys, I wanna live to see my grandchildren. Congenital heart issues affect approximately 40,000 people born each year in the U.S. and are one of the most common types of birth defects. The surgeon I used told me that he had performed keyhole surgery once but wasnt sure if it would be of much benefit to me. Lack of breath? Im not looking forward competitions nor marathons. The false lumen extending into the abdominal aorta was left since the point of origin in the ascending aorta was repaired. Still no stenosis or regurgitation, aorta now 35 mm, he is 6 ft, 150 pounds. I went through the regiment of meds that are prescribed post AFIB. Bicuspid aortic valve (BAV) disease is the most common congenital heart defect, as it affects 1.3% of the adult general population . 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. Since he had to stop playing.. depression has set in. I dont know anything about crossfit but I see his times are average on that page. Do you have any info or recommendations about this? There are a lot of variables here, even from the short story youve shared. Thank you so much. Mild degrees of aortic regurgitation are usually well-tolerated and do not produce symptoms. Bicuspid aortic valve (BAV) disease does not usually cause symptoms. My name became public 25 years ago this week. I did run 1-2 times/week for a 1.5 months now, the situation is getting a little better but still I feel like a 80 years old. Yes, I am aware of the work by Dr. Dietz. Thank you for your expert opinion. running? 2k erg test. Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. I dont know all of the important details. This makes the aortic valve a tricuspid valve. It sounds like youre off to a good start with your recovery. I had an exercise tolerance test recently and they seemed happy with my results so fingers crossed thats a good indication I can carry on training hard! I would really like for people to not have to experience what I had to experience, she continued. Also I lift weights . Other heart parameters are very good (no bigger chamber or aorta). 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. In fact, in some people they can go undiagnosed for years. An abnormal aortic valve develops during the early weeks of pregnancy, when the baby's heart is developing. My cardiologist Said to not lift heavy weights. Aortic Stenosis This might reasonably translate into some measurable improvement related to physical exercise. My son was diagnosed with BAV, by chance, when he was 7. I dont believe there is any evidence that would help us know if some forms are safer than others. I had multiple re-hospitalizations but seemed to recover. I am 46 years old today, 22x marathoner, 4x Ultra (50 miles) and 5x natural fitness competitor. Males are about twice as . This international evidence-based nomenclature and classification consensus document is intended for universal use by clinicians, imaging specialists . "Schwarzenegger's pulmonic valve was successfully replaced.". If the valve does not close completely, blood can leak into the heart. 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 . I have 5 children, so I dont want to drop dead and leave my poor wife with them all to look after on her own. A bicuspid aortic valve is a congenital heart defect that affects the one-way valve between your heart and your aorta, known as the aortic valve. Perhaps a cardiac surgeon would be able to provide even more detailed information about things like various options for operation that might be applicable in your case as well as thoughts about when operation should be performed. I had AVR exactly 1 year ago to the date. 2. While I recovered from surgery just fine, my return to my normal activity levels has been hampered by recurring arrhythmias, muscle atrophy during recovery, medication,and general inability to exert myself like I could prior to surgery. Get on with it. Review of the clinical records of 152 patients aged 20 years and older found to have a bicuspid aortic valve at autopsy revealed aortic stenosis in only 28 percent. Common symptoms include chest pain, shortness of breath, dizziness and fainting. Is there any research on this? I have been feeling better than before the surgery and I feel with better condition on the trails. He left it pretty vague. 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. Consensus guidelines are developed to be broadly applicable, but the guidelines may not be applicable in a given athlete patients circumstance. And its always valuable to frame up discussion in terms of how much risk is acceptable. In practice, the indications for aortic valve replacement for severe aortic stenosis or severe aortic regurgitation are straightforward and uncontroversial. The procedure was performed at the Cleveland Clinic. I would not want yo distinguish between the various forms of static exercise that you mention. More difficult questions relate to what are acceptable sports/exercise if operation is not (yet) needed. 1) What kind of sports are recommend to me according to my situation? I now take diltiazem daily. (Or do I just need to train even harder??). "Weve gotten a lot closer and weve learned each other on a whole different, deeper level, she told PEOPLE in 2015. Here are stories of some celebrities with this condition: Not everyone who has a congenital heart defect knows about it, so its important to be vigilant about the health of your heart. Could I continue to train and just cut out the blood chokes? The actress, 44, found out she had a leaky valve in 2002. Our only tool to keep track of aortic enlargement is repeated measurements with CT or echo. John Ritter - Actor - passed away due to undiagnosed CHD at age 55. triangle chokes, other blood chokes) could be putting pressure on my heart and cause my aorta diameter to increase? Many patients with surgery for BAV, even if it involves aortic root replacement, lead rather normal lives afterwards. In March 2018 he underwent emergency surgery to have this replacement valve replaced. Next year I would like to finish my first marathon but now I dont know whether I should keep running. is my lack of top end performance indicative of someone with BAV & aortic coarctation? I recently also did a 24hr EKG (holter) which was fine. Thank you! Etc? Anyway, talk to a surgeon who understands quality of life means. In general, the larger (in diameter) the substitute valve is, the less aortic stenosis it will produce. Have you considered meeting with a heart surgeon to talk about the situation? Join Vanity Fair to receive full access to VF.com and the complete online archive now. What Is Bicuspid Aortic Valve Disease? In addition to being patients, there are many celebrities who, like you, parent a child with CHD as well. Always best to heed the advice of your doctor(s) who will be in the best position to offer advice about safe forms of exercise. Arnold Schwarzenegger Helped Greta Thunberg Get a Tesla, Where to Watch the Biggest 2023 Awards Contenders. I dont have any ayptoms. In some cases, the aortic valve can be repaired and the enlarged aorta can be replaced with a Dacron tube. What should i do? Even if its one person I help. Throughout the years he has played football and basketball. He is very athletic. That post is a starting point for todays discussion. 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. In fact, one young man died 5 years after operation (from other non related causes) and the study on his aorta tissue revealed that the device helped it to heal, presenting a healthy histology. Its not around incision, its mainly middle of left side. 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. Both are important in deciding if and when operation is needed. In some cases, bicuspid aortic valve causes another condition called aortic valve stenosis. "Know the symptoms ladies," she wrote. Most probably not pericarditis cause I had it once so I know that pain type, but again, maybe its some other type. My performance as a cyclistgiven my ageputs me in the elite category, although with the stenosis I am experiencing a definite decline in performance. Randyyour situation has many similarities to mine; I would be very interested in sharing experiences. I certainly know of athletes who return to all forms of endurance sport as well as weight-lifting after operations like yours. Surgery. 140 miles at race pace. Keep us posted! I know that heart surgery can be scary.but I also know that for the vast majority of patients with these conditions, surgery goes well and the outcomes are good. I used to do quite some running 10 years ago (still at amateur level), I was doing lots of 10k and 20k and even I managed a marathon in 3h:26min (but at that time I didnt know about the BAV). 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. Can you clarify what may not be true please? 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. It's the most common type of congenital heart disease (heart defect that's present at birth) and often goes unnoticed until later in life. Is it like keyhole surgery? I think we would expect less enlargement over time with stopping strenuous exercise. 2 Such features need to be considered before surgical intervention. It makes the heart work harder than it should. Finally some solid information about exercise and life post AVR, thank you very much for that. However, my problem is that if I can train at this pace then I can still run but I certainly cant compete! There have been reports of lingering effects (decreased function of the left or right ventricles) for several days after marathon runs. Patients with BAV who have a normal size aorta, with no stenosis or regurgitation of the aortic valve, can participate in sports without restriction. Routine endocarditis prophylaxis is . Thanks for sharing an update. Star Jones. He was forced to stop playing football at 11. Aortic replacement. We are now seeing moderate stenosis, hence replacement in the not too far distant future. Ten years ago (2006), doctors said that there was a worsening of the BAV but still no need to have Aortic replacement. Im 53. Best Valentine's Day Restaurant Specials 2023. I first wrote about BAV in a short post here at the blog back in 2009. So far, none of the people that had the operation suffered any dissection. Thoracic aortic aneurysm, an abnormal bulge in the part of the aorta located in the . 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. Went through the process of antibiotic therapy and. My questions are: can my root dilation remain stable? Having a congenital heart defect means you are born with a problem with the heart's structure. Moreover, there is a myriad of operations that such patients may have had, each with its on set of considerations. these conditions occur mostly during my exercises at the gym and Im left very lightheaded and shortness of breathe. I was wondering if you could give your opinion on my scenario. His doctor said his heart look very healthy and no other issues. His favorite sports are football and baseball. Its probably not possible to have too much information as you think about your situation. "I Googled 'womens' heart attack symptoms,' " her blog post continued. Nwankwo Kanu (@papilokanu), the Olympic Gold Medalist (Soccer) suffered from Aortic Valve Defect. Your doctors will be in the best position to offer advice because they will be most familiar with your case. I will update you all after his Friday appointment. Athletes with mechanical or bioprosthetic heart valves may participate in low and moderate intensity sports, Athletes who are taking blood-thinning medications should avoid sports where bodily injury, with potentially life-threatening bleeding, might occur. Athletes should have detailed discussion with their doctors about any prudent limitations to exercise after operation and settle on a mutually agreeable plan. 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. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. The studies on Irbesartan for Marfans(I dont have Marfans) are showing some positive outcomes; and. Bicuspid aortic valve is a type of abnormality of the aortic valve. Mild to moderate ai Push for earlier date? Anyway, his aorta was growing at a rate of 2 mm per year (he was growing faster:).and they put him on 100 mg Losartan. 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. 2012; 109:1632-1636. I am a marathoner with BAV and no other cardiac issues. He will be rechecked with an echo, BNP blood test & MRI every 6 months. PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. Here is a link to a diagram that categorizes sports according to their dynamic and static components: http://www.athletesheart.org/wp-content/uploads/2013/12/Classification-of-Sports-300217.png. Interesting situation Sean Miller. I have also been advised that running intervals at over 80% max heart rate would not be sensible. Doing nothing wont be great for my heart and wont extend my life neither probably.. I love running. Kinda like a marathon but it will take me at least 9 hours. My son is 15 and has grown about 4-6 inches in the last year. Maybe thats not surprising, given that Im a heart surgeon and that many individuals with BAV need operation at some point. Approximately 1%-2% of the population are born with an aortic valve that only has two cusps. I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. My son is 15 years old, he was born with BAV /aortic stenosis. Benefits: no blood thinning (with attendant risks) needed. She says now it is stable and I dont have to see her for 2 years. My mom [and aunt] passed away [in their 60s from heart disease], and my dad had a heart attack when I was around 10 and he had a triple bypass, the actress told PEOPLE. Notify me of follow-up comments by email. will need careful consideration by your physicians who know all of the pertinent details. Sadly, we dont have a crystal ball, though to know what the future holds for any particular individual. I used to run a lot. In fact, like most people, the 25-year-old had never heard the term before. I feel fantastic and have already been walking the streets of Cleveland enjoying your amazing statues. People can live normal lives with Congenital Heart Defects. Thank you for this blog! I got Edwards magna perimount 25mm bovine AV and Valsava graft for aortic root replacement. In some cases a particular arrhythmia that is responsible for your feelings of palpitations or light-headedness could be identified.and options for treatment could be presented. Like you point out, its always wise to be vigilant after surgery for things that might be amiss.and get checked out. 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. I am a 48yo competitive cyclist who is very concerned with being able to return to my former ability to hit high effort levels following open heart surgery. (bicuspid aortic valve), singer Bret Michaels (atrial septal defect), and even 'Survivor' contestant Whitney Duncan (ASD). Given my age and activity level, do you think it would be beneficial, or even prudent, to explore a valve repair surgery as you described above? (I am on a low dose beta blocker) 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. With the blood thinning needed for a mechanical valve, serious bleeding may occur with injuries. Most children with BAV will remain without symptoms until adulthood. 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 probably get more inquiries from athletes with bicuspid aortic valve (BAV) than any other single heart problem. Typically, the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two cusps (bicuspid aortic valve). This is true at rest and may be even more so during exercise. 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. 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I have question about your opinion about aortic valve regurgitation (no BAV) Down side: must take blood thinners to prevent blood clots from forming on mechanical valve. The valve will become healed (scarred) into the surrounding heart tissues with the passage of time. The only question I have is in regards to having my children screened. Context Bicuspid aortic valve is the most common congenital cardiac anomaly in the adult population. when I discussed this with my Dr. he reassured me that its not my heart causing it. His story is typical. I have been doing as much research as possible on what are the advantages/disadvantages of each replacement. "Women are the natural caregivers; we take care of everyone else under the sun," she says. Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. No one loves life more than I do, read the statement. Often times, especially for patients with tissue heart valve replacement devices, the valve simply wears out. lessons) Enjoy! What he did say is there are no signs of stenosis, and my heart looks very strong. 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. enlarged LV = 350ml Hey would like to continue to be active but is worried about which procedure would be best for him. Last echo measurements LDid 6.3cm z-score 2.4, LVIDs 4.1 cm z-score 2.0, LVPWd 1.2cm z-score 1.9, asc aorta Diam 4.0 cm z-score 5.8. I was diagnosed age 4 and am now 35. Congenital heart issues affect approximately 40,000 people born each year in the U.S. and are one of the most common types of birth defects. Thank you for nice article. Now, fully healed thanks to two stents in her arteries, Lucci is spreading the word. Thanks so much In the simplest terms, a bicuspid aortic valve can be a serious heart valve disorder in which the valve only has two leaflets, or flaps, that control blood flow through the heart. Hey has been physically active with restrictions of no contact sports, and no isometric exercise. "I had to make lifestyle and diet changes, she said. Have completed an excercise stress test and signed off as ok on reaching level 13. His aorta is lightly enlarged. We just saw the cardiologist in July and again same symptoms and no significant cardiac changes . Glad Ive found this website! To revist this article, visit My Profile, then View saved stories. Bicuspid aortic valve (BAV) is the most common form of congenital aortic valve disease, in which the valve has only two leaflets instead of the usual three; it affects up to 2% of the population. Do you think the weights Im doing at the moment seem OK with those results ? 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. Glad to hear that youve found a surgeon and settled on a plan. I have found out I have a BAV last year. Does lifting weights up to 100 pounds and being cleared for push-ups, pull-ups, all cardio, etc., sound reasonable? The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). Not sure I have something specific to suggest for additional reading.and I dont know where to steer you about a knowledgeable trainer in the UK. I appreciate your input. I made appointment with my cardio, to clear that up, dont worry :). 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. You are correct that we worry about the influence of such activities on the enlarged aorta in those with BAV. Im in Philly today but Im from Central NY. Hi Dr. Creswell. I seen my cardiologist yesterday and this is the first year in 4 years that the aneurysm hasnt grown a mm. I get the fact that lifting excessively can cause a spike in blood pressure, but only under certain conditions (i.e.