Stenosis limits FAA

[P1GLX]

Hi all.

Had a cardio CT scan recently that revealed 30% stenosis by area of the left anterior descending coronary artery. The CAA limit is 30%, does anyone know the limit for the FAA.

Does anyone know if this could be corrected by an angioplasty or stent, there is also a procedure called rotoblating.

My cardiologist has advised me that my level of stenosis does not warrant any procedure and suggests I retire - not what I wanted to hear!!

Advice from any source would be most appreciated.

[Radgirl]

The normal advice would be to get a second opinion. No sensible doctor will object. It is difficult to give definitive advice on this thread but isolated single occlusions are often left. They may well be suitable for stenting but the risk of stenting may be more than the risk of leaving it.

Sorry I cant help about the FAA. You may want to ask the radiologist to give a more accurate percentage for the stenosis - they often round it by 10 or 20 percent as it doesnt matter for non pilots in the same way. You may find if you explain why it needs to be below 30% a second measurement might come back as 29% .......

I would talk to your cardiologist about retirement - he may well have said this based on cardiac risk - discussing the risk itself might help you to formulate your thoughts and plans....

[Nightstop]

I was in a similar situation about 20 years ago. I had a heart attack. An angiogram revealed stenosis in my left anterior descending artery (LAD) and an ejection fraction (EF) less than 50% (the CAA limit). My cardiologist said I was unsuitable for stenting and that was that. He also wouldn't recommend bypass surgery as my condition wasn't bad enough, yet! I sought a second opinion (Dr Webb-Peploe) and was told a bypass would probably improve the ejection fraction but until it was done no one knew by how much. Weighing up the risk against the reward, I decided to go ahead with the Op. Post operative tests confirmed my EF was now in excess of 50%. My medical certificate was restored and I've been flying commercially with an OML and annual stress ECG's ever since. I was much younger though than P1GLX at the time of my Op. Only he/she can decide which path to follow next. Good luck.

[AngioJet]

(a) Are you completely asymptomatic, and if so, what was the reason for the cardiac CT?
(2) If you are indeed asymptomatic, an angioplasty of the stenosis would likely carry risk in excess of any benefit, and would probably be best avoided
(3) The gold standard for the assessment of the degree of coronary artery stenosis is still a coronary angiogram, ie an invasive procedure. I concur with the recommendation to get a second opinion. It is notoriously difficult to assess the exact degree of stenosis, especially if the vessel is calcified, which often results in an overestimation of the narrowing on CT.

Good luck!

PS: Rotablation is a procedure done for chronic total occlusions (CTO) of the coronary arteries. Would not be done for a simple stenosis such as yours.