Heart Valve Surgery Keeps Pilot's Heart in the Clouds

Pilot Damian Vasquez's main heart valve had become defective. His choice: have it surgically corrected or quit flying. There was no question. He needed to fly.

heart valve surgery keeps pilot's heart in the clouds
Cardiologist John Raniolo, DO, diagnosed pilot Damian Vasquez's narrowed aortic valve.

There isn't a better feeling than flying a plane, according to commercial pilot Damian Vasquez. "Every day you get a bird's-eye view, sunrise ... sunset. It's amazing," he said. There's no better feeling, he repeated — unless it's getting paid to fly a plane!

"I picked up the fever for flying in high school, and it became a passion," he said. Damian, 42, graduated from Embry Riddle Flight School in Prescott and flew for almost a decade as a cargo pilot for Ameriflight, LLC.

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This article appears in the September - October 2013 edition of HealthBeat, John C. Lincoln's free health newsletter.

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It was the perfect job, until it wasn't.

To understand what happened to Damian, said cardiologist John Raniolo, DO, you have to understand how the Federal Aviation Administration protects the public by medically certifying pilots.

The FAA designates specially trained physicians to become Aviation Medical Examiners (AME). They perform flight physicals for all pilots at regular intervals.

Without a successful and current flight physical, you can't legally fly. If an airman develops a disqualifying medical condition, like Damian did, the pilot's medical certificate is no longer valid.

That's how Damian Vasquez and Dr. Raniolo met. Almost two years ago, Damian's Aviation Medical Examiner diagnosed a murmur in Damian's heart and referred him to Dr. Raniolo.

Narrowed Aortic Valve

Damian had a medical condition called aortic stenosis, Dr. Raniolo said. The aortic valve became calcified and narrowed over time, restricting blood delivery to the body's vital organs. Damian's medical condition was genetically based. His choice was have it corrected or quit flying.

"There was no question. I would have the surgery," Damian said. Dr. Raniolo referred Damian to cardiovascular surgeon Ken Ashton, MD.

Because Damian's aortic valve had narrowed, his heart was working harder at a higher pressure.

In surgery at John C. Lincoln Deer Valley Hospital, "we used a traditional approach, opening Damian's sternum, which gives us better visibility," Dr. Ashton said. "As soon as we put Damian on the heart-lung bypass machine, we were able to surgically remove his defective valve and replace it with an artificial valve. It all went very smoothly."

Damian said the Deer Valley staff was great, "and the facility was amazing. If I ever had to go back, I would never want to go to any other hospital."

Damian's medical information was reviewed by the Federal Air Surgeon's Cardiology Consulting panel, on which Dr. Raniolo serves. If the pilot's medical information meets FAA standards, he/she can be granted a time-limited Special Issuance authorizing him to resume flying.

Damian has since undergone postsurgical cardiac testing, which he hopes will result in being granted a Special Issuance that will authorize him to resume active flying status.

If Damian were not a professional pilot, he might have been able to delay surgery, Dr. Raniolo said. But the FAA takes its responsibility to the public very seriously, resulting in stringent standards.

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