Flying after mitral/aortic valve replacement with pacemaker

[FastEddieB]

I tried to send this via dm to Dr. Chien, but was unable:

Dr. Chien,

Tomorrow will be 6 months since my surgery - mitral and aortic valves replaced and a pacemaker installed. I seem to be fully recovered.

I know the surgery grounded me for 6 months, and I’m now weighing my options.

1) Can I go ahead and fly as a Sport Pilot?

2) If not, and I need a special issuance to resume flying, how difficult a process is that? I also had a prior special issuance for kidney stones, which still occasionally recur. Can you recommend anyone in the Knoxville/E TN area that could help guide me through the process?

If it’s all too burdensome, it’s not the end of the world - 50+ years and 7,000 hours without accident or violation was a good run regardless.


Thanks in advance,

Ed Benson

 

[GeorgeC]

Can I go ahead and fly as a Sport Pilot?

Why not?

 

[Kenny Phillips]

Under MOSAIC rules you can fly quite a few larger planes, including some 182s.
I'm doing that whilst working through my medical.

 

[FastEddieB]

Why not?

Heart valve replacement seems to be on the list of disqualifying conditions for Sport Pilot.

Others have disagreed, but it seems pretty clear. Hence needing to find out who might be able to guide me through the process of getting a Special Issuance, so I can decide if it’s even worthwhile at this point.

 

[Capt. Geoffrey Thorpe]

Heart valve replacement seems to be on the list of disqualifying conditions for Sport Pilot.

Where is this list?

There is a list for basic med - but I have never seen one for us light and sporty types. Just the "not know of any condition..." and "neither revoked or denied..."

 

[FastEddieB]

Where is this list?

There is a list for basic med - but I have never seen one for us light and sporty types. Just the "not know of any condition..." and "neither revoked or denied..."

You may be right, and I hope you are. I guess the assumption is that anything on the FAA list of disqualifying conditions could render one “…unable to operate the aircraft in a safe manner”. But I don’t know if that’s ever been explicitly ruled.

 

[Lindberg]

I guess the assumption is that anything on the FAA list of disqualifying conditions could render one “…unable to operate the aircraft in a safe manner”.

That would be a flawed assumption and contrary to the regulation.

 

[FastEddieB]

That would be a flawed assumption and contrary to the regulation.

In the absence of anything concrete from the FAA, I hope you’re right.

I’m still vacillating on whether this might be an opportune time to hang up my spurs gracefully. It’s been a good run. And I have lots of other satisfying hobbies to keep me quite busy in retirement. Still plenty of time to decide. The most important thing is the surgery seems to have been a success with a fairly rapid recovery and no apparent limitations*. And for that I’m grateful.




*Tuesday’s e-bike ride. The pacemaker is completely transparent, and I’m well on my way back to the condition I was in pre-surgery. Which makes me very happy, and was almost inconceivable immediately post-surgery.

 

[Dana]

In the absence of anything concrete from the FAA, I hope you’re right.

He is right. If the FAA wanted to add disqualifying conditions for sport pilot, they would be in the regs (as they are for basicmed), but they didn't. This has been discussed and analyzed in multiple previous threads on the subject.

 

[GeorgeC]

my understanding:
class 1/2/3: it's between you and the FAA, open kimono.
BasicMed: it's between you and your doctor, except for the enumerated list of disqualifying events (cardiac valve replacement among them)
sport pilot: it's between you and Odin (14 CFR 61.53), assuming you have a DL and your medical has not been revoked or denied.

 

[Lindberg]

In the absence of anything concrete from the FAA, I hope you’re right.

They say that hope is not a strategy. Nor is it a doctrine of statutory interpretation.

I’m still vacillating on whether this might be an opportune time to hang up my spurs gracefully. It’s been a good run. And I have lots of other satisfying hobbies to keep me quite busy in retirement. Still plenty of time to decide.

An entirely different question, and obviously one that only you can answer. There's certainly a peace in winding down on your own terms. And happiness is a blessing that can't be overstated.

The most important thing is the surgery seems to have been a success with a fairly rapid recovery and no apparent limitations*. And for that I’m grateful.

Indeed!

 

[Mark K]

So here's my general medical information/nonadvice, (you know, I'm not your doctor, this is not specific advice to you since I don't know your full medical history, seek specific advice tailored to your situation from your actual doctors as to your fitness to fly, etc, etc)

There is ambiguity in the sport pilot rules. On one extreme, "anyone with a DL can fly sport pilot..." This is one extreme view. During my three decade career as a practicing physician, almost functioning fully as a gerontologist, there are many people with a DL that are frankly unsafe to pilot an aircraft. On the other extreme, the list of 15 disqualifying conditions for a medical certificate can't be applied directly to sport pilot because it creates a conundrum where getting a sport pilot license would be technically harder than getting a medical certification. Why? Because a good number of the 15 can be SI'd. There is no SI process for sport pilot. If you take the position you can't have a disqualifying condition, then it would be de facto harder to fly under sport pilot. This is not likely the intent of the sport pilot rule.

Since it's common for pacemakers and valve replacements to get SI'd as long as the history is low risk, i.e. no significant coronary blockages, no h/o significant arrhythmia that the pacemaker can't control, normal heart pumping function, no other high risk features increasing their chance of sudden cardiac arrest/pilot incapacitation, then, as long as they follow the rules of their thoracic surgeon/cardiologist/internist, and they've been released unrestricted, that person would likely get an SI. And so, I think, it would be reasonable to fly under sport pilot.

Dr Chien may not want to offer an opinion on whether you are ok to fly sport pilot because technically, that is not his role. He can help you get a medical certification though. If you want to pursue an SI, he may be able to help. If you want to fly sport pilot he is not in a position to render any sort of specific opinion for you. Technically speaking, he doesn't offer medical opinions. He helps folks get medical certifications. And, part of Dr. Chien's value is that he is extraordinarily good at knowing when the FAA will not render an opinion in your favor and when it will.

 

[Half Fast]

The most important thing is the surgery seems to have been a success with a fairly rapid recovery and no apparent limitations

The pacemaker is completely transparent, and I’m well on my way back to the condition I was in pre-surgery

Eddie, that says to me that you’re not aware of any condition that would prevent you from operating an aircraft safely. Given that you still have your DL, you’re legal to fly. Flying will be less stressful to your heart than the e-bike, and much less stressful than your motorcycle (remember- we’ve ridden together!).

If you’re nervous about going up, take along a healthy, young (and inexperienced, by your standard) CFI for the first couple of flights.

Stop overthinking the legality and go fly!

 

[FastEddieB]

So here's my general medical information/nonadvice…

Thank you so much. That was a very helpful and well reasoned post.

I had extensive tests prior to my surgery - heart cath, lung function, and others I’m sure I’m forgetting. My impression was we caught the valve deterioration early enough that my heart was otherwise quite healthy. I basically had no symptoms going in, and I had to take on faith the cardiologist’s and surgeon’s dire predictions that I needed to do something post haste. And all my followup visits have shown normal function now. In fact, I assume my heart is a more efficient pump now that the leaky valves have been replaced.

So, I’m comfortable that I can certify that I currently have no known condition that would preclude safe flight, and that that meets the letter of the law for a Sport Pilot.

 

[jordane93]

Not exactly your situation but my dad had bicuspid valve surgery about 6 years ago and was told he could be back flying within a year on a special issuance first class. He took some more time off though. Our airline union wasn’t too concerned with him not returning and said it is a relatively common surgery. He did not have a pacemaker installed so I’m not sure if that adds extra hoops. Hope you get back soon!

 

[bbchien]

Sorry that I missed this. If you have not had a denial (or a failed application), I suggest fly either BASIC or Sport Pilot. Although, third class is possible if you want to jump the squares!