Compared to our own native valve, all of the available prosthetic substitutes have a small degree of aortic stenosis built in, unfortunately. From afar, its hard to know what might be responsible for your symptoms. Sometimes patients with mechanical aortic valves report that they lose a bit of their top-end athletic performance. At this time, it is not known whether Arnold received the new valve using a surgical aortic valve replacement (SAVR) or atranscatheter aortic valve replacement (TAVR). Susp. Thanks for the article! Im paranoid to exercise too much for fear that I will do damage to the valve. Im aware that those days are past, but to abandon every activity seems like a prison sentence What is safe side threshold? Ordinarily, we reserve operation for patients with severe aortic regurgitation who have some decrement in the LV function. What advise can you give to someone in my position? Likewise, if I did a 60kg bench press I could easier than say an 18 year old girl started at the gym tried that, they would have to strain beyond belief. The pitfall, though, is that our native aortic valve is itself very efficient. While she ended up being okay, she advised other women to be more cautious. Im am in stres ?! 1. But, while doing my cardio stress test they discovered that I have a Bicuspid Aortic Valve. It has allowed me to do the thing I enjoy doing in life. Hi Sean, His whirlwind romance with Katherine Schwarzenegger has resulted in a rather large ring on her finger. He isnt interested in anything else. I would not want yo distinguish between the various forms of static exercise that you mention. The aortic valve is between the left lower heart chamber and the body's main artery, called the aorta. It was her death that prompted me to get checked out. However, some people are born with an aortic valve with only two leaflets, known as a bicuspid aortic valve. Contemporary reports suggest that life expectancy with BAV is no different from the general population. She advised us we should start to consider surgery but would follow up with us again in 3 months. Kimberly was born with an abnormal valve, but didn't begin to develop symptoms until her 40s. It would be great to know what happens to groups of patients after AVR and aortic replacement that have returned to their various sports. She was originally under the impression she felt the way she did simply because she was exhausted. Athletes will ask when they can return to their sports. We saw cardio in April again and my sons symptoms are the same and no progression on the aortic regurgitation. Thank you for what you do and for your responsiveness. I have only played a few games of football in the last 5 years due to a knee injury but I have continued running for fun and do 5k in a reasonable 25 minutes. Thats about as specific as he got. When we go back to re-replace a patients prosthetic valve, for some reason, it usually has to be chiseled out from the heart. New guidelines from 2015 are in accord with your doctors recommendations about vigorous exercise as well as periodic imaging to measure the aorta. Jones' goal with the AHA is to help women "actively put themselves on the track to heart health." what recommend me? Unfortunately, I really cant point you to such studies. I dont know why this formed as I have had the problem valve replaced many years ago. Great article! And during the years, this remained pretty stable. For the last 7-8 years I didnt do too much sport (kids, family). Bobbie. Because BAV may be an inherited condition, Athletes with BAV, no significant valve stenosis or regurgitation, and an aortic diameterless than 4.0 cm can participate fully in their sport(s), Athletes with BAV and enlargement of the aorta to between 4.0 and 4.5 cm can participate safely in only low and moderate intensity sports (this would. A week after he made the varsity team as a freshman he was told by the doctor he couldnt play. But I recognize that not all cardiologists or heart surgeons would agree. I dont think theres a way to predict the future in this circumstance. There was only a 0.2 cm increase in the previous 7 years (so from age 21 to 28). At the age of 12, she had a procedure to widen her valve as her heart condition continued to have an impact. I see Im not alone. 2023 Cond Nast. This award-winning website has helped over 10 million people fight heart valve disease. All aorta is normal, valvula normal funkcion only sinus valsava 35-37mm. 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. On Ocotber 23, 2020, we learned that Arnold Schwarzenegger had a third heart valve procedure, a re-replacement of his aortic valve replacement. We have contacted the Cleveland Clinic to learn more and will report back soon. Normal great vessel size As a consequence, these individuals develop earlier calcification of the valve leaflets, leading to narrowing, or stenosis. I have only trivial aortic regurgitation. Less 100mmhg. 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. They may also disrupt the normal flow of blood through the heart. 2k erg test. The truth is that there is not much scientific information about what happens to such athletes if they do return to endurance sports. 2) He can lead a normal life & can continue his training with regular echocardiography control (once in a year). I dont doubt there is variability in recovery among athletes who have operation for AVR and aortic replacement. O'Donell took the aspirin recommended for people who think they are suffering a heart attack just in case, but didnt call 911. I cant do that justice here. A HR limit of 120 will be tough, I would guess. Its really not strenuous, maybe 10 km/h and not more that 10 push ups at once. Based on the information Ive provided, I would greatly appreciate your advice and opinion on the matter. 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. . Now I take brisk walks and run on the treadmill only occasionally. 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. The surgery was a full success, and the valve is closing really well now. Early after operation, and for perhaps the first month, we typically limit activities that place stress on the shoulders and sternum. Bicuspid aortic valve is the most common congenital cardiovascular anomaly, occurring in 1-2% of the population. He just turned 15 he is 511 203 lbs and has a heart of gold. He was very talented at football. 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. 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. Hello Dr. Creswell, The more common form of bicuspid aortic valve occurs in a valve with three cusps with . Hi all, Etc? Abstract. I played competitive amateur football (soccer) on Saturday and Sunday from age 16. A cadaver if valve is then used to replace his pulmonary valve. This is the only measurement that has gone down . will need careful consideration by your physicians who know all of the pertinent details. thanks for sharing all this interesting info. Dr. Larry, I do appreciate your insightful article very much. We go back in 3 months for another echo. Open heart surgery is sometimes the best option, but it is not always the only option. During that first month we recommend ample walking as the best form of exercise. Normally, your aortic valve has three cusps that regulate blood flow from your heart to your aorta. Arnold Schwarzenegger (The Governator) - Heart Valve Replacement. Should I increase amount of weight? To me, cardiologists are not sports people and air on being absolutely over cautious. When patients have moderate to severe aortic regurgitation, exercise can often be difficult. My question is if my weight&lack of training or my BAV is the cause of difficulty in running. But for those WITH such problems, we do recommend curtailing either static or dynamic activities, or both. Did you run? My son was just told he made the varsity basketball team as a freshman. I would encourage you to have further discussion with your doctor(s) about EXACTLY what forms of exercise are safe. When first diagnosed with BAV I just nodded and smiled it was only the following day that reality hit home and I thought of all of the questions that I would have liked to have asked the cardiologist! Like you, I have been frustrated by the lack of experience and information that the cardiology community has for folks like us, although it is encouraging to read everyones posts here and see that we are not alone. For example, are there data that shows what happens to aortic diameters once sports have been stopped? Sory but I dont speak very vell english. It has served me well enabling me to live the vigorous, full, complete life you are all so familiar with. Zdenko . Only two cusps, commissures and sinuses are seen in the less common "pure" bicuspid aortic valve subtype. Dear Dr Creswell you seem to be such a kind cardiac surgeon to make yourself available in answering questions. I dont believe there is any evidence that would help us know if some forms are safer than others. Like you mention, one theory is related to the aortic blood flow. Are there any things I can do now to help minimize my risk? What he did say is there are no signs of stenosis, and my heart looks very strong. Best Valentine's Day Restaurant Specials 2023. Im 33 from UK and have known about my BAV since I was around 18. Good to hear that youre doing well. Nwankwo Kanu (@papilokanu), the Olympic Gold Medalist (Soccer) suffered from Aortic Valve Defect. Frankly Im worrying quite a bit about thisand I feel like its causing additional chest pain and shoulder pain. CT or MRI may be more accurate. Historically, a heart murmur was the most common reason affected individuals were identified. Its very helpful for people with heart problems. Is this a possible explanation? 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. It seems to be a very interesting option for those who have aortic dilatation due to Marfan or BAV (which is my case). ANYTHING other than walking and golf? Down side: durabilitythe borrowed valve doesnt last forever; it will deteriorate and need re-replacement at some point. I dont know what to do .. PS: I noticed that the option Notify me of follow-up comments by email doesnt seem to work. 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. What does heavy weights mean? I know I will need it replaced. Thank you so much for all of this insightful information. 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. http://www.24hourgym.us. Ive yet to feel like Im back to my previous racing fitness that I once had. I am a 23 year old male, have BAV with mild AR. John Fox, NFL coach, suffered from Aortic Valve Disease. Most patients (like me), however, start to experience problems during their 30s, 40s, and 50s. In March 2019, media outlets hailed two new studies on transcatheter aortic valve replacement (TAVR) as potentially signaling the beginning of the end of open heart surgery for aortic stenosis. I cant lift over 40lbs and I cant continue my work as a tradesman as it requires lifting over the 40lb mark. Measurements of aortic diameter can be made with echocardiogram. If the valve is smaller than needed, there can be a limit to the ability of the heart to do extra workand that can show up as less speed. O'Donnell suffered a heart attack in 2012, and wrote about her experience on her blog. Options for operation 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. Probably wise to follow the advice of your doctors who know the details of your situation. The material on this site may not be reproduced, distributed, transmitted, cached or otherwise used, except with the prior written permission of Cond Nast. However, there are few reports about the safety and efficacy of TAVI in type 0 BAV. They wont repair my aneurysm unless it was 55mm during surgery or 60mm before surgery. Ordinarily, race walking is considered to be in the same category of activity as long-distance running. For those same patients, we recommending avoiding strenuous dynamic exercise line swimming, running, soccer, tennis, cross-country skiing, etc. Im hoping you can help with some guidance. Star Jones. The aortic valve allows oxygen-rich blood to flow from the heart to the aorta. 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 would really like to know if I can (or shouldnt) push myself as hard as I used to. Garth was already familiar with heart diease before her diagnosis because it runs in her family. I love running. A bicuspid aortic valve: Most people are born with an aortic valve that has three leaflets (a tricuspid aortic valve). Do you opration? I lifted weights for many years and spent almost all my life in physically demanding jobs. 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. I have recently found out that I have aortic regurgitation will soon be needing surgery. The rest of the aorta is normal (visualized to just above the bifurcation in the abdomen). Reply. "Schwarzenegger's pulmonic valve was successfully replaced.". People can live normal lives with Congenital Heart Defects. Ive thought that the next visit to the pediatrician would be a good opportunity to discuss the issue. I believe that many Cardiologist are not as experienced regarding how to advise high-performing athletes (even older ones like us). I just need to know if these sports are a possibility (im pretty sure football is a no given its contact nature). I would just like to share my experience of having a Aortic Valve replacement. And lastly, the degree of healing in the remaining (unoperated) aorta probably has a big impact on the potential risk. Most people require treatment once symptoms develop. He is certainly expert in the area of drug therapy to reduce the rate of aortic enlargement. Sometimes my cardiologist says there is minimal change and he thinks my aorta had slightly enlarged by 1-2mm. In the 2.5 years from surgery, I returned back to riding within the first 3 months and later back to longer, decent training pace rides and racing but feel like I have lost my top end mojo. About a year ago a pulmonologist discovered a grade 2/6 heart murmur during a workup for a sleep study. The ST junction and ascending aorta are mildly dilated max 35mm. That said, the recommendations dont address WHEN that screening should occur. 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. I was shocked. Next year I would like to finish my first marathon but now I dont know whether I should keep running. 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. Some good points there, Craig. Call 911. I had an echo because of a scuba diving accident and was discovered to have a BAV (no PFO). My cardiologist is not concerned. Thanks a lot for your answers. No aortic root dialation. 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. "Thanks to the team at the Cleveland Clinic, I have a new aortic valve to go along with my new pulmonary valve from my last surgery," he wrote. Hi . My questions are One doctor to told me just to control it and train as I like but the other one said that with those hearts parameters I will have only 1-2% to have operation in the future but if I will continue to do triathlon for sure I will have to have one. 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. The bicuspid aortic valve opens and closes abnormally, and can result in leaking of the valve. Perhaps meeting with a heart surgeon now, even if operation is not yet needed, might provide a forum for discussion about the options for surgery, the technical issues, and recovery. I have also spoken with Boston Childrens Hospital who have been very helpful and enlightening. Hi. "I Googled 'womens' heart attack symptoms,' " her blog post continued. Notify me of follow-up comments by email. Since I started running, I lost about 8 kg, my blood pressure decreased from 140/90 to 120/80-70. 1. 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? We just saw them in January. 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. Perhaps you could organize such a visit for a 2nd opinion regarding safe levels of exercise? Schwarzenegger was born with a condition known as bicuspid aortic valve, in which the heart's main artery, the aorta, has only two cusps instead of three. I would like to get back into it, but obviously I have been having some concerns. 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. Post 2 years and Ive yet to get back to my high level of racing fitness and wanted to see what should be expected. Normal biventricular size and function, no scar. Randyyour situation has many similarities to mine; I would be very interested in sharing experiences. Im not surprised that youve received a conservative recommendation about exercise. I have repeatedly asked each follow up, if continued marathon training is OK. Im always told it is fine with the old adage of listening to your body. When Ive had patients in your situation, Ive usually recommended getting the screening when its CONVENIENT. 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? This can be very frustrating to athletes who are used to being more active. My daughter has played two years of varsity basketball already. Hey has been physically active with restrictions of no contact sports, and no isometric exercise. 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. Would you recommend taking beta-blockers at this stage? After a 6 month ramp up, will the Porcene valve take the stress of the 5 rep sets?
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