Cardiovascular Disease: Valvular Heart Disease

Valve (Mechanical or Bioprosthetic) Implantations with a Transcatheter or Surgical Approach

LEOs should be restricted for 3 months post procedure and cleared for full duty if they meet all of the following criteria post procedure: 

• Asymptomatic (e.g., no symptoms of reduced cardiac output, no signs of arterial emboli, etc.) 
• ECG with normal sinus rhythm 
• EST to at least 12 METS with normal findings 
• Baseline (1-3 months post procedure) echocardiogram showing: 
  • Normal let ventricular ejection fraction (LVEF), and 
  • Normal left ventricular end systolic dimension (LVESD), and 
  • Normal left ventricular end diastolic dimension (LVEDD) 
  • Not on anti-coagulation medications 

Follow-up Evaluation for Valve Replacement: LEOs who have undergone a valve replacement should have an annual evaluation by a cardiologist or other physician knowledgeable in the treatment of cardiac valvular disease. For bioprosthetic valves, echocardiograms should be done annually for transcatheter procedures, and every 5 years for bioprosthetic values replaced surgically.1 Routine echocardiograms for mechanical replacement valves are not required.1 Results of the physician evaluations and the echocardiograms should be shared with the agency’s medical provider.