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Exertional Collapse in a Runner With Mixed Aortic Valve Disease: Return to Training After Ross Procedure
Ranvir Bhatia1, Robert Zorc1, Jennifer Digian2
1Penn Sports Cardiology and Fitness Program, Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background:
Bicuspid aortic valve represents a rare but important cause of sudden cardiac death in athletes.
Case Summary:
A 48-year-old runner with a bicuspid aortic valve with significant mixed aortic valve disease experienced a pulseless electrical activity arrest after a race and underwent a Ross procedure. Fifteen months after surgery, he presented to clinic for guidance on return to training. After reassuring cardiopulmonary exercise testing and shared decision-making, he has returned to training without complications.
Discussion:
This case highlights considerations of the Ross procedure in the adult athletic population, the complex nature of aortic valve disease in athletes, and guideline-directed postarrest evaluation and return to sport.
Take-Home Messages:
While the Ross procedure offers unique advantages, further data are needed to assess durability in adult athletes. Athletes with at least moderate aortic valve disease warrant formal exercise testing and consideration of sport-specific stressors.
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