Contemporaneous management of valvular heart disease and aortopathy in aircrew

Joanna L. D'Arcy, Thomas Syburra, Norbert Guettler, Eddie D. Davenport, Olivier Manen, Gary Gray, Rienk Rienks, Dennis Bron, Edward D. Nicol*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish
Pages (from-to)S57-S63
StatePublished - 1 Jan 2019
Externally publishedYes


  • aortic and arterial disease
  • health care delivery
  • valvular heart disease


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