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Contemporaneous management of valvular heart disease and aortopathy in aircrew

Valvular heart disease (VHD) is highly relevant in the aircrew population as it may limit appropriate augmentation of cardiac output in high-performance flying and predispose to arrhythmia. Aircrew with VHD require careful long-term follow-up to ensure that they can fly if it is safe and appropriate...

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Autores principales: D’Arcy, Joanna L, Syburra, Thomas, Guettler, Norbert, Davenport, Eddie D, Manen, Olivier, Gray, Gary, Rienks, Rienk, Bron, Dennis, Nicol, Edward D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256303/
https://www.ncbi.nlm.nih.gov/pubmed/30425087
http://dx.doi.org/10.1136/heartjnl-2018-313056
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author D’Arcy, Joanna L
Syburra, Thomas
Guettler, Norbert
Davenport, Eddie D
Manen, Olivier
Gray, Gary
Rienks, Rienk
Bron, Dennis
Nicol, Edward D
author_facet D’Arcy, Joanna L
Syburra, Thomas
Guettler, Norbert
Davenport, Eddie D
Manen, Olivier
Gray, Gary
Rienks, Rienk
Bron, Dennis
Nicol, Edward D
author_sort D’Arcy, Joanna L
collection PubMed
description Valvular heart disease (VHD) is highly relevant in the aircrew population as it may limit appropriate augmentation of cardiac output in high-performance flying and predispose to arrhythmia. Aircrew with VHD require careful long-term follow-up to ensure that they can fly if it is safe and appropriate for them to do so. Anything greater than mild stenotic valve disease and/or moderate or greater regurgitation is usually associated with flight restrictions. Associated features of arrhythmia, systolic dysfunction, thromboembolism and chamber dilatation indicate additional risk and will usually require more stringent restrictions. The use of appropriate cardiac imaging, along with routine ambulatory cardiac monitoring, is mandatory in aircrew with VHD. Aortopathy in aircrew may be found in isolation or, more commonly, associated with bicuspid aortic valve disease. Progression rates are unpredictable, but as the diameter of the vessel increases, the associated risk of dissection also increases. Restrictions on aircrew duties, particularly in the context of high-performance or solo flying, are usually required in those with progressive dilation of the aorta.
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spelling pubmed-62563032018-12-11 Contemporaneous management of valvular heart disease and aortopathy in aircrew D’Arcy, Joanna L Syburra, Thomas Guettler, Norbert Davenport, Eddie D Manen, Olivier Gray, Gary Rienks, Rienk Bron, Dennis Nicol, Edward D Heart Standards Valvular heart disease (VHD) is highly relevant in the aircrew population as it may limit appropriate augmentation of cardiac output in high-performance flying and predispose to arrhythmia. Aircrew with VHD require careful long-term follow-up to ensure that they can fly if it is safe and appropriate for them to do so. Anything greater than mild stenotic valve disease and/or moderate or greater regurgitation is usually associated with flight restrictions. Associated features of arrhythmia, systolic dysfunction, thromboembolism and chamber dilatation indicate additional risk and will usually require more stringent restrictions. The use of appropriate cardiac imaging, along with routine ambulatory cardiac monitoring, is mandatory in aircrew with VHD. Aortopathy in aircrew may be found in isolation or, more commonly, associated with bicuspid aortic valve disease. Progression rates are unpredictable, but as the diameter of the vessel increases, the associated risk of dissection also increases. Restrictions on aircrew duties, particularly in the context of high-performance or solo flying, are usually required in those with progressive dilation of the aorta. BMJ Publishing Group 2019-01 2018-11-13 /pmc/articles/PMC6256303/ /pubmed/30425087 http://dx.doi.org/10.1136/heartjnl-2018-313056 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Standards
D’Arcy, Joanna L
Syburra, Thomas
Guettler, Norbert
Davenport, Eddie D
Manen, Olivier
Gray, Gary
Rienks, Rienk
Bron, Dennis
Nicol, Edward D
Contemporaneous management of valvular heart disease and aortopathy in aircrew
title Contemporaneous management of valvular heart disease and aortopathy in aircrew
title_full Contemporaneous management of valvular heart disease and aortopathy in aircrew
title_fullStr Contemporaneous management of valvular heart disease and aortopathy in aircrew
title_full_unstemmed Contemporaneous management of valvular heart disease and aortopathy in aircrew
title_short Contemporaneous management of valvular heart disease and aortopathy in aircrew
title_sort contemporaneous management of valvular heart disease and aortopathy in aircrew
topic Standards
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256303/
https://www.ncbi.nlm.nih.gov/pubmed/30425087
http://dx.doi.org/10.1136/heartjnl-2018-313056
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