heart valve replacement
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Join Date: Nov 2001
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heart valve replacement
HELLO,
I would like to hear from pilots who have had aortic valve surgery and still flying, if there are any. I am particularly interested in Aortic regurgitation surgery. I have a lot of questions but would be very grateful if any pilots could let me know if they have been through this process. I look forward to replies. Thanks
I would like to hear from pilots who have had aortic valve surgery and still flying, if there are any. I am particularly interested in Aortic regurgitation surgery. I have a lot of questions but would be very grateful if any pilots could let me know if they have been through this process. I look forward to replies. Thanks
Join Date: May 2000
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Don't know if this will help but here is what the FAA require. As it says at the end each case is considered individually. The basic rule that the FAA works under is that if you can show you pose no risk to flight safety then they have no problem with you flying. This is not the case with the JAA so I would assume that they probably would make it a lot harder for you.
Here is the FAA's position
Special Issuance Procedure After Heart Valve Replacement
A six-month recovery and stabilizing period (or longer, if clinically indicated) shall have elapsed after the surgery. Your application cannot be considered until after six months have elapsed. If a valve repair is performed instead of a valve replacement, the FAA requires three-months of stabilization and recovery.
After the recovery period, a packet of medical records and a current cardiovascular evaluation must be completed and presented to the aviation medical examiner at the time of your FAA medical examination. The packet must include:
A request for special issuance under FAR 67.401.
Copies of all clinical and hospital records and diagnostic test reports pertaining to the valve replacement. Hospital records must include admission and discharge summaries, operative reports, history and physical exam, daily progress notes, and laboratory work. Also, the make, model, serial number, and implant location of the valve should be included.
A current cardiovascular evaluation (performed at least six months after the event and submitted to FAA within 90 days after testing) including:
Assessment of personal and family medical history.
Clinical cardiac exam and general physical exam.
Blood lipid profile, including total cholesterol, HDL, LDL, triglycerides, and plasma glucose level.
Assessment and statement regarding medications, functional capacity, modifiable cardiovascular risk factors, motivation for necessary change and prognosis for incapacitation.
Maximal ECG exercise stress test demonstrating minimal functional capacity equivalent to completion of Stage III of the standard 12-lead Bruce protocol. It is preferable that you reach as close to maximum predicted heart rate (220 minus your age) as possible to demonstrate good exercise capacity. Should you be unable to reach target heart rate because of fatigue, leg cramps or shortness of breath, a minimum of 85% of predicted rate must be achieved. (NOTE: Do not exceed your maximum predicted rate.) If beta blockers are being taken, it may be necessary to discontinue the medication for 48 hours prior to testing to achieve the required heart rate. Consult with your cardiologist before stopping medication. All tracings and blood pressure/pulse recordings must be submitted along with the doctor's interpretation.
24-hour Holter monitor with representative tracings
Current 2D, M-mode, and Doppler echocardiogram. Include the video of the study.
(Required only if anticoagulant is being used.) A current evaluation from your attending physician regarding your use of anticoagulants to confirm stability without complications and to include dose schedules, actual prothrombin time (PT) and control determinations and International Normalized Ratio (INR) accomplished at least monthly during the past six-months of observation.
SPECT nuclear cardiology studies using technetium and/or thallium 201 or cardiolite may be required if clinically indicated or if the ECG exercise stress test is equivocal, positive for ischemia, or indicative of ventricular dysfunction or other significant abnormalities. ALL reports of imaging, electrocardiographic tracings, blood pressure/pulse recordings, and the actual scintigraphic film (FAA prefers black and white monochrome) should be included.
The special issuance review process can take up to three months or longer. Each case is evaluated on an individual basis and difficult cases can require longer review time. Delays are assured if any of the required information is not included.
If you need to contact FAA, use the following address and phone number:
Federal Aviation Administration
Aeromedical Certification Division
P.O. Box 26080
Oklahoma City, OK 73126
Attn: Appeals (AAM 321)
Phone: 405/954-4821
Here is the FAA's position
Special Issuance Procedure After Heart Valve Replacement
A six-month recovery and stabilizing period (or longer, if clinically indicated) shall have elapsed after the surgery. Your application cannot be considered until after six months have elapsed. If a valve repair is performed instead of a valve replacement, the FAA requires three-months of stabilization and recovery.
After the recovery period, a packet of medical records and a current cardiovascular evaluation must be completed and presented to the aviation medical examiner at the time of your FAA medical examination. The packet must include:
A request for special issuance under FAR 67.401.
Copies of all clinical and hospital records and diagnostic test reports pertaining to the valve replacement. Hospital records must include admission and discharge summaries, operative reports, history and physical exam, daily progress notes, and laboratory work. Also, the make, model, serial number, and implant location of the valve should be included.
A current cardiovascular evaluation (performed at least six months after the event and submitted to FAA within 90 days after testing) including:
Assessment of personal and family medical history.
Clinical cardiac exam and general physical exam.
Blood lipid profile, including total cholesterol, HDL, LDL, triglycerides, and plasma glucose level.
Assessment and statement regarding medications, functional capacity, modifiable cardiovascular risk factors, motivation for necessary change and prognosis for incapacitation.
Maximal ECG exercise stress test demonstrating minimal functional capacity equivalent to completion of Stage III of the standard 12-lead Bruce protocol. It is preferable that you reach as close to maximum predicted heart rate (220 minus your age) as possible to demonstrate good exercise capacity. Should you be unable to reach target heart rate because of fatigue, leg cramps or shortness of breath, a minimum of 85% of predicted rate must be achieved. (NOTE: Do not exceed your maximum predicted rate.) If beta blockers are being taken, it may be necessary to discontinue the medication for 48 hours prior to testing to achieve the required heart rate. Consult with your cardiologist before stopping medication. All tracings and blood pressure/pulse recordings must be submitted along with the doctor's interpretation.
24-hour Holter monitor with representative tracings
Current 2D, M-mode, and Doppler echocardiogram. Include the video of the study.
(Required only if anticoagulant is being used.) A current evaluation from your attending physician regarding your use of anticoagulants to confirm stability without complications and to include dose schedules, actual prothrombin time (PT) and control determinations and International Normalized Ratio (INR) accomplished at least monthly during the past six-months of observation.
SPECT nuclear cardiology studies using technetium and/or thallium 201 or cardiolite may be required if clinically indicated or if the ECG exercise stress test is equivocal, positive for ischemia, or indicative of ventricular dysfunction or other significant abnormalities. ALL reports of imaging, electrocardiographic tracings, blood pressure/pulse recordings, and the actual scintigraphic film (FAA prefers black and white monochrome) should be included.
The special issuance review process can take up to three months or longer. Each case is evaluated on an individual basis and difficult cases can require longer review time. Delays are assured if any of the required information is not included.
If you need to contact FAA, use the following address and phone number:
Federal Aviation Administration
Aeromedical Certification Division
P.O. Box 26080
Oklahoma City, OK 73126
Attn: Appeals (AAM 321)
Phone: 405/954-4821
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Hi Inverted Flatspin,
Thanks for your reply. It gives me a good idea of the process.
Actually, I am holding a JAA Class 1 medical.
I realy appreciate your post and I am sure the JAA medical requirements must be very similar.
However if anybody knows the exact spec following this kind of surgery in Europe under a JAA licence or had been in this unfortunate position, please let me know.
Thanks for your reply. It gives me a good idea of the process.
Actually, I am holding a JAA Class 1 medical.
I realy appreciate your post and I am sure the JAA medical requirements must be very similar.
However if anybody knows the exact spec following this kind of surgery in Europe under a JAA licence or had been in this unfortunate position, please let me know.
