Pedi CardioRef
Reference: ACC/AHA Sports Participation Recommendations (Circulation 2015) Task Force 5: Valvular Heart Disease

participate in organized sports?

Should my patient with a history of aortic or mitral valve surgery participate in organized sports?

Need to know:

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(Aortic or mitral) bioprosthetic valve, not on anticoagulants

"It is reasonable for athletes with aortic or mitral bioprosthetic valves, not taking anticoagulant agents, who have normal valvular function and normal LV function to participate in low-intensity and some moderate-intensity competitive sports (classes IA, IB, IC, and IIA)."

If normal valvular function, normal LV function: Class IA, IB, IC, and IIA sports = reasonable

(Class IIa Recommendation; Level of Evidence C)

(Aortic or mitral) mechanical valve, on anticoagulants

"Athletes with aortic or mitral mechanical prosthetic valves taking anticoagulant agents with normal valvular function and normal LV function can reasonably participate in low-intensity competitive sports if there is low likelihood of bodily contact (classes IA, IB, and IIA)."

If normal valvular function, normal LV function: Class IA, IB, IIA sports = reasonable, if low likelihood bodily contact

(Class IIa Recommendation; Level of Evidence C)

Mitral stenosis, s/p either surgical commissurotomy or percutaneous balloon valvotomy

"It is reasonable for patients with MS who have undergone successful percutaneous mitral balloon valvotomy or surgical commissurotomy to participate in competitive sports based on the residual severity of the MS or MR and pulmonary artery pressures at rest and with exercise."

Depending on residual valve dysfunction and PA pressures at rest/exercise: Sports may be reasonable

(Class IIa Recommendation; Level of Evidence C)

Surgical repair (for MR, or aortic valve repair)

"Athletes who have undergone mitral valve repair for MR or surgical aortic valve repair, have no or mild residual AR or MR, and have normal LV systolic function may be considered for participation in sports at the discretion of the managing physician if there is low likelihood of bodily contact (classes IA, IB, and IIA)."

If no/mild residual AR or MR, normal LV systolic function: Class IA, IB, IIA sports may be considered if low likelihood bodily contact (at discretion of physician)

(Class IIa Recommendation; Level of Evidence C)

Reference: Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities. Task Force 5: Valvular Heart Disease. A Scientific Statement From the AHA and ACC. Circulation 2015

Disclaimer: This website is derived from published guidelines, but does not constitute medical advice nor does it replace clinical judgement. Only the text in quotation marks are direct quotations from the original guidelines. Text not in quotations as well as the method of information display are all that of the website creator and are not part of the original published guidelines. Please consult a physician to discuss any patient-specific matters.

Key: MR = mitral regurgitation, AR = aortic regurgitation, MS = mitral stenosis, AS = aortic stenosis, LV = left ventricle