I’ve been competing in triathlons for over 10 years with an emphasis on IM over the last several years including two in 2006. 12days ago I had open heart surgery to replace my aortic valve.
I’m looking for anyone else who has gone through this or a fairly similar situation that can discuss their own experience with returning to training and competing.
Thanks.
I am glad to hear you had a successful surgery and that you are able to get back into training. I assume you have to go ahead from your doctor.
I didn’t have anything as serious as that, but I did have Ventricular Tachycardia a few years back when I was doing marathons. I had a procedure done and was able to train again soon after. Best of luck to you!
Stacy T.
konaboundstacy.blogspot.com
What kind of valve?
KY, is that you?
Eric
Trey
I went with the mechanical valve to replace the aortic valve. Thus I will be on coumadin the rest of my life as well. I’m only 36y/o and didn’t want to go through OHS one or two more times. I hope there is an advancement in the medicine available and that some day there will be a drug other then coumadin.
Yeah Luckydog it’s me!!
KY
Tough situation UD, and I wish you best of luck with your recovery. Hopefully you are feeling a good bit better by now since you must have been pretty symptomatic to earn an AVR at your age. Presumably your doctor has given you instructions on return to activity over the first few months post-op.
Disclaimer: I am not a surgeon or a cardiologist. I am an epidemiologist, and my main area of research is cardiovascular surgery outcomes. Meaning that I deal with populations rather than individuals. You should get medical advice about your specific situation from your cardiologist.
Once everything has healed up, you should be able to return to whatever activity you can tolerate. Mechanical valves have somewhat reduced hemodynamic performance compared to native or tissue valves, but the modern ones are actually very good and the fact that you like longer distance events may actually be fortuitous in that regard, since the intensity is lower. There is almost nothing in the literature about long-term athletic performance following mechanical AVR, but there are plenty of anecdotal reports of active people and even pro athletes going back to high levels of physical activity. If your current cardiologist does not work with athletes, I’d encourage you to find one who does. The vast majority of what most cardiologists see is degenerative disease in old people and your situation is very different. Many people will think marathon running or ironman distance triathlon is out of the question, but as I say, there’s no literature to support this view. In fact, I’d be much more concerned about your trying to return to a career as an 800 meter track athlete than an iron distance triathlete. So work with a sports cardiologist to put together a training plan and you’ll do great.
Trey thanks for the info.
I was diagnosed 3 years ago with aortic regurgitation due to a bi-cuspid valve. Looking back on it I think I started feeling the slow slide at the end of last year but it came to an end a month ago when during my IM training I couldn’t run more then 2 miles or bike more then 15 minutes without getting short of breath. I was admitted to the hospital with CHF. It’s interesting that you said that now you would be more concerned if I did a 800 meter race now then an endurance event. After being diagnosed in 2004 with aortic regurg. out of the three opinions I got only one cardiologist said I should stop doing IM but sprint races would be fine.
There doesn’t seem to be many people in my situation and thus no sample group to do a study. I think if I went from one cardiologist to the next I would get personal opinions and not scientific ones.
I might just be the guinea pig for this.
Sorry to sound dumb but can you explain " hemodynamic performance " Thanks!
There’s no dumb question when it comes to your health!
Hemodynamic performance has several components, but mainly in this situation has to do with how much pressure is lost as blood flows across the valve from the left ventricle to the aortic root. A large “gradient” or loss of pressure across the valve indicates that the valve is impeding ejection of the blood from the heart (all other things regarding cardiac function being equal). Mechanical valves tend to produce somewhat larger gradients than tissue valves or pulmonary valves switched to the aortic position in a Ross procedure.
In your case, with a bicuspid valve, you may have had some degree of stenosis or valvular incompetence for most of your life, and you may not have any noticeable impairment from a mechanical valve. Short distance events, being run at a much higher intensity, are more dependent on maximal cardiac output than longer endurance events. Increases in pressure gradient are more likely to be troublesome in cases of high flow demand.
People for some reason think longer events are more “stressful” and therefore are to be avoided. Maybe for the entire organism “more stressful” is true. As far as your mechanical valve is concerned though, ticking along at the cardiac output required for an IM should not be a big deal, and should be less demanding than trying to keep up in a sprint.
Hi Trey
Well I’m starting to workout again and need some guidance. Can you help me with finding a sports medicine cardiologist in the Chicago land area? I’ve tried searching and can’t find anyone with that double specialty. Any help in directing me where to start would be appreciated. I’ve lost faith in my cardiologist after asking him about beginning training he said just take it slow and that I know my body and the effects of training. He also didn’t think a stress test or VO2 max test were necessary. He just said that my heart was healthy and that the mechanical valve should hold up to endurance exercise, and since I had no other heart issues not worry. He has just ordered a yearly 2d echo and cut my beta-blocker in half, with hopes of stopping it all together in 6 months.
Thanks
Great to hear you are back to training! Did the docs give you any special instructions about the coumadin? I was wondering if they gave you warnings to always go to the ER after trauma (like a bike crash) to rule out internal bleeding.
Do you have any leftover discomfort from your sternum?
Jodi
I don’t have any personal contacts in cardiology in Chicago, but this guy would be a good place to start:
http://www.schosp.org/findadoc/profile.asp?d=36042099
He is head of Cardiac Rehab at Swedish Covenant, is a Fellow of the American College of Sports Medicine and IIRC is a retired ultramarathoner.
If that doesn’t work out try me again. I know quite a few vascular surgeons up there I could ask, but they tend to refer to cardiologists for sick people. You want a well people’s cardiologist.
Thanks Jodi
Yeah the docs said that I need to seek medical attention anytime I fall down and go boom. I’m also carrying medical supplies, gauze,tape,band aids. As well as wearing a medical alert bracelet(road ID). I still have some sternum discomfort(8.5 weeks post-op) but it’s mainly only to the touch and strong coughs. The muscle and cartlidge damage is still tender as well. Still no swimming or weights yet.
Thanks Trey
Since you know some surgeons in the area maybe you know Dr. Bakhos. He was my Cardiovascular surgeon. I’ll look into the sports medicine physician but it concerns me that he is out of Swedish Covenant Hospital, they have a really bad reputation. If you hear of any others please let me know.
Thanks
Best of luck to you…
In Sept. 2005, I had surgery to repair my mitral valve and to replace my dilated aortic root with a Dacron graft. (No, I have no other symptoms of Marfan’s, I’m 6’1" and 175 lbs with normal proportions, etc.) Luckily, my mitral valve was repaired and my aortic valve was healthy, so no blood thinners. I was back on an exercise bike in four weeks, teaching spinning classes again at lower intensity after about 2.5 months, and back to about 70% fitness wise six months post op. However, I was still bothered by persistent post op atrial fib and other arrhythmias and a left ventricular ejection fraction less than 30%.
A catheter ablation procedure in June 2006 fixed the arrhythmias (or so I thought) and my ejection fraction came right back to normal when my heart was able to beat correctly again. My fitness was back to a high, near normal level after about a year following my original surgery (functional threshold on the bike > 300 watts, regularly sustaining > 340 watts on 10 - 15 min climbs).
Just three weeks ago, on the evening of Aug 6, I was doing my normal training ride and had just recovered from a fairly aggressive 10 min climb (HR back down to 126 bpm according to my file) when within one second (my SRM was recording in one second intervals) I went into V-tach at 239 bpm and from there into full cardiac arrest. I was riding alone, but luckily two pedestrians saw me go down, called 911 and did CPR. Police and ambulance arrived promptly and after an estimated 7 minutes in cardiac arrest I was defibbed back to life on the fourth shock. I should be dead right now, but thanks to some caring bystanders, great emergency response, a high level of fitness, a guardian angel who was very much on the ball, and probably more dumb luck than anyone deserves I’m alive today with no real impairment other than some short term memory loss that lasted for about 24 hours after I went down. I still don’t remember the ride, but I have an SRM file that tells the story. I was back to training and teaching fitness classes within two weeks of the incident, but I’m now the proud owner of an implanted defibrillator even though doctors couldn’t re-induce the arrhythmia in the hospital after the event.
Bottom line (my opinion only, I’m not a doctor), fighting as hard as you can to rehab yourself after surgery will allow you to resume your life as it was before surgery, but remember you will never again be “normal”. Pay attention to any rhythm abnormalities as they very well could be fatal.
Uh oh. That’s good to know, thanks. I’ll make some phone calls and let you know what I can find out.
I still have some sternum discomfort(8.5 weeks post-op) but it’s mainly only to the touch and strong coughs. The muscle and cartlidge damage is still tender as well. Still no swimming or weights yet.
Wait till you hear the crunching noises from the scar tissue when you do get back to the weight room. 
That is the most astonishing thing I’ve ever heard. You are truly unbelievably fortunate to have come through an arrest like that and done well. If you’ve never thought about writing a memoir about this experience, you should.
Justcurious
I agree with Trey that is an amazing story and comeback! However you have scared be back into fearing a return to this sport. I’ve never had an arrythmia of serious magnitude let alone one like that. But now my fear is, can I or am I at more risk to now?
That is the most astonishing thing I’ve ever heard. You are truly unbelievably fortunate to have come through an arrest like that and done well. If you’ve never thought about writing a memoir about this experience, you should.
If I only had a dollar for every time I’ve heard that, I could quit my job.
It’s hard to believe it even happened, as my mind is still pretty much blank from when I left the house on my ride until I was answering questions in the hospital a few hours later. Pretty tough to write a memoir when you have no memory of the event.