Heart Valve Surgeries and the FAA medical certificate
As a pilot with the experience of three mitral valve surgeries (one repair and one Mitral valve replacement surgery in 2009, and one recent Mitral valve replacement in March 2022) I can tell you that after going through a successful TAVR, you will need to go through the hoops of obtaining a Special Issuance Class III medical.
Regardless of which consulting AME or AOPA medical expert you contact, you will get the same direction. That is, you will have to submit an echocardiogram report, a 24 hour Holter monitor report, a stress test on a treadmill as prescribed by the FAA, lab reports of blood analysis, a report from your Interventional Cardiologist or Surgeon, and probably a few more reports that I can't recall right now.
I am preparing to go through this experience myself. When I had surgery in March, 2022, my Basic Med certificate was no longer valid because my FAA Class III Special Issuance was no longer valid. [OP edit…A better way to say this would have been “…my Basic Med was no longer valid because I had been diagnosed with a new Cardiovascular condition listed by the FAA.”] I have waited because I want to be sure I am completely recovered and rehabbed before requesting the Class III SI.
Yes, I am aware that if I fail the Class III Special Issuance, then I would not qualify for the Basic Med certificate. Further, unless things have changed, I would not be able to legally fly as a light sport pilot. However, I believe I can pass the Class III Special Issuance this time just like I did over 12 years ago.
There is no need for you to even think of appealing to the NTSB. The regulations are very explicit on what the FAA medical office requires for pilots who have had heart surgery, even a Trans Arterial Valve Replacement as you had. I don't have the regulations in front of me, but since you are a pilot, you should be able to find what is required for you to continue to exercise the privileges of a private pilot.
My Cardiologist told me recently that my surgery, recovery and rehab exceeded his expectations. And I feel very healthy. But neither my family practice physician nor my Cardiologist is an FAA AME. Regardless of how your physician views your health, the FAA medical staff has the final say.
I will not submit anything, repeat anything, to the FAA medical office without first allowing the AOPA Medical staff the opportunity to review my submittal. In all likelihood you will learn patience, although I understand the FAA has "streamlined" their process for approving Special Issuances. After my 2009 surgeries it took six months of waiting after surgery just to begin the process and then another six months of submitting and submitting some more information to finally get my Class III Special Issuance. It is possible the TAVR surgery will not require as rigorous a review as a surgery requiring a sternotomy. For your sake, I hope so.
Good luck, and let us know how it turns out.
P.S. For those readers who are wondering, “TAVR” refers to “Transcatheter Aortic Valve Replacement” which typically only requires the patient to stay one night in the hospital. Due to advances in cardiac medicine, the mitral valve can also be a candidate for a transcatheter procedure. Thus, “TAVR” has morphed into the more general “Trans Arterial Valve Replacement.” Both procedures, either aortic or mitral valve replacement, are usually performed by an Interventional Cardiologist, although a Heart Surgeon is usually close by should he or she be needed.
Also, although I am not a Physician but merely a heart patient who has undergone three heart surgeries and I am currently an Accredited Visitor of heart patients through membership in The Mended Hearts organization, I am willing to share my heart surgery knowledge with anyone who is interested. Please contact me by PM.
