Aortic valve replacement

[Tim]

I'm 45 years old & have been an avid runner for 23 years; have never any medical problems, shortness of breath or cardio-type symptoms. As recently as 3 years ago ran a 60 mile ultramarathon....A recent physical & subsequent echo indicate I have a congenital heart defect. Where most aortic valves have 3 flaps, I have 2. Leakage & enlargment is occurring. Cardiologist advises stopping running, weight lifting & all excersize besides walking. Surgery not imminently imperative; could watch it for a year. Indicates I probably would not be able to run (much)after valve replacement. I consult with a surgeon in a week.....In general terms, given my history, does the "no running"(even moderate)interim direction seem appropriate? - -I had something in Runner's World magazine that indicated that excersize does not worsen aortic insufficiency or hasten the time to valve replacement. Since the blood only leaks between beats, there's less leaking during excersize(?)......With non-mechanical aortic valve replacement, isn't it possible to consider a return to running at some level after recovery? Thanks!

[CCF CARDIO MD - DLB]

These are all good questions. You are right - the amount of leak can actually decrease while exercising due to the increase in the heart rate, though whether that actually happens in an individual is complex. If exercising caused the blood pressure to become very high, the leakage could increase. However, in a well-conditioned athlete, I would not expect this to happen to a great extent. I think continuing to exercise in a moderate fashion is OK, though I would avoid heavy-weight lifting and would avoid competitive running. However, most cardiologists would give the same advice that yours did - that it is safer to avoid doing anything strenuous until after the surgery. In a runner, I would recommend an aortic homograft instead of a mechanical valve - you would probably be able to keep running with a homograft.

[Tim]

Thanks a lot for the good input!...One follow-up question...while my doctor says surgery is not imperative yet, and took a neutral stance on going ahead vs. waiting & monitoring, I indicated that by waiting I'll just be older & not in as good physical condition (he didn't disagree). I'll keep an open mind, pending my discussion with my surgeon, but if it's likely the surgery will be necessary at some point in the future,I'm feeling like it may be better to proceed at this point (if surgeon seconds opinion)....My logic making any sense? Thanks!

[CCF CARDIO MD - DLB]

Your approach is logical. I agree with your cardiologist and have a neutral stance. My real answer would really depend on just how bad the leakage is and how your heart (on the echocardiogram) is responding to the added workload. Unlike in certain situations, surgery for aortic valve regurgitation can sometimes be safely deferred with medications. However, you are right that surgery will ultimately be necessary.

[Hank Eyring]

Hello There Tim,

I am writing you to let you know about a list that myself and several other Heart Valve Replacement patients have created.

I am a 33 year old male who had aortic valve replacement surgery in April of 1999.  I often had questions about stuff like what do other people’s spouses think about their valves clicking, to how do the kids deal with Dad having major surgery.  Also issues about what is involved in approaching surgery, going through surgery and recovering from surgery. We also discuss the use of coumadin since most of us have to take it for the rest of our lives.

If you would like to join a mailing list along with folks who have been through this kind of stuff before and are facing it in the future, just go to the following URL and sign up.

http://frontpage.inficad.com/~hanky/heart.htm

You will find much help with this list and we all learn from each other.

Hope you can join us,

Hank Eyring