Aortic Valve Replacement

[Coffee thanks!]

Hello,

Is there anyone out there with knowledge of Aortic Valve replacement and when an aortic valves deterioration affects your class 1 medical. Is replacement mainly based on pressure gradient and if so what is the mm hg gradient that triggers grouding or alternatively replacement surgery? I have heard that in the general population replacement is considered around 60mm gradient, but for aircrew about 40mm gradient. does this sound about right? As I understand it pig valves can regain your class 1, but mechanical valves mean permanent grounding. Any advice welcome.

Thankyou and Regards,

[Flyin'Dutch']

Hi,

Am not sure whether there is a different limit for 'the general public' and aircrew but you may well be right. Those pressures seem to be about in the right ballpark.

Mechanical valves last longer/indefinitely/don't need replacement normally but require lifelong anticoagulation with a bloodthinning agent. Over here in the UK we would use Warfarin on the continent Sintrom/Coumarin. They are agents which interfere with the bloodclotting cascade.

Bio-valves (Pigs) wear out after a while (?10-15years) but no need for anticoagulation.

Although the idea of a heartvalve replacement is daunting and the operation a serious matter, the vast majority of people do very well following replacement surgery.

I see you are in Oz so check the implications for your medical with CASA, although I think you are correct, and obtain further, more to the case applicable information from the medics involved.

If it is about you all the best and hope all goes well, if it is for a friend you are asking wish them well.

Ciao

FD

[ausdoc]

The rules in Aus for Aortic valve replacement are:

Corrected Aortic Stenosis
Class 1, 2 and 3 Medical Certificates

On diagnosis of the condition, inform CASA Aviation Medicine Section and advise applicant not to exercise the privileges of his/her licence until investigations have been completed and results assessed as satisfactory by CASA.

Recertification

Investigations required for recertification are:

Routine aviation medical examination

Cardiologist’s assessment

ECG

Doppler echocardiogram

Chest X-ray.

If all of the investigations and the cardiologist’s reports are satisfactory, the applicant may be recertificated for a period of 12 months.

Where a tissue (pig) valve is used and there is no requirement for anticoagulation, medical certification may be unrestricted.

Where a mechanical valve is used, the applicant is to have evidence of clinically satisfactory well-controlled anticoagulation, and Class 1 medical certification will be restricted to multi-crew operations.

Subsequent Review
Class 1, 2 and 3 all require annual review by a cardiologist.

Hopes this helps a bit. Even a mechanical valve is not grounding, but may be restrictive depending on what type of flying you do.

Cheers,

ausdoc

[R2000]

Thanks all for your answers. Very informative. I had to re-register hence the new login name.

My cardiologist has told me that whilst my current military pilot employment would probably not be affected just yet, that any potential future employer ie airline, would probably not be happy to accept me. :{

Thanks again,