Angina, Angioplasty, Bypass, CAD, Heart Attack, Stent

Angina, Angioplasty, CAD, Heart Attack, Stent

The FAA has amended the required observation and recovery time for applicants who have had coronary artery disease treated with uncomplicated Percutaneous Transluminal Coronary Angioplasty (PTCA) with stent placement.  For all classes of medical certification, a three-month recovery and stabilization period is now required after most stent procedures (See details below). The requirements now include:

 

3rd class medical certification-Stent:

 

A current cardiovascular evaluation that must include:

 

  • Hospital Admission History and Physical report;
  • Hospital Operative report;
  • Hospital Discharge summary;
  • All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
  • Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination;
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides;
  • A comment regarding your medication, the dosage, and frequency of use.
  • A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III  (9 minutes) of the 12-lead Bruce protocol. (Performed no sooner than three months after the stent procedure).

1st and Unlimited 2nd* Class Medical Certification-Stent:

  • Hospital Admission History and Physical report;
  • Hospital Operative report;
  • Hospital Discharge summary;
  • All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
  • Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination;
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides;
  • A statement regarding your medication dosage and frequency of use;
  • A three-month post event coronary angiogram including catheterization films, reports, and line drawings of coronary anatomy;
  •  A maximum radionuclide exercise stress test with complete tracings of the exercise portion of the test and radiographic images of the nuclear scans (Performed no sooner than three months after the stent procedure).

 

*An unlimited second-class medical has no functional limitations. A limited second-class medical may be issued, sometimes without the need for repeat coronary angiography, to pilots who need limited commercial privileges; however, a nuclear exercise treadmill test will be required for limited second class consideration. The limitations usually include "Not valid for carrying passengers or cargo for compensation or hire," "Not valid for PIC," or "Valid only when serving as a pilot member of a fully qualified two pilot crew." A limited second class also allows full third class privileges.

 

Coronary Artery Bypass Grafting-All Classes:

 

Six months of observation and recovery is still required for all classes if treatment included coronary artery bypass surgery with open revascularization using cardio-pulmonary bypass.

 

  • Hospital Admission History and Physical report;
  • Hospital Operative report;
  • Hospital Discharge summary;
  • All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
  • Cardiologist report including:
  • An assessment of personal and family medical history;
  • Cardiac examination and general physical examination;
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides;
  • A statement regarding your medication dosage and frequency of use;
  • 3rd Class - A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol. (Performed no sooner than six months after the bypass surgery).
  • 1st and Unlimited 2nd Class - a six month post event coronary angiogram and a maximum nuclear exercise treadmill stress test is required for initial consideration after bypass surgery. (Performed no sooner than six months after the bypass surgery).

Left Main Coronary Artery (LMCA) Stenting

 

For all classes, a stent to the left main coronary artery requires six months of recovery.

 

3rd Class Medical Certification (LMCA):

  • Hospital Admission History and Physical report;
  • Hospital Operative report;
  • Hospital Discharge summary;
  • All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
  • Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination;
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides;
  • A statement regarding your medication dosage and frequency of use.
  • A maximum exercise treadmill stress test demonstrating functional capacity equivalent to completion of Stage III (9 minutes) of the 12-lead Bruce protocol. (Performed no sooner than six months after the stent procedure).

1st and 2nd Class Medical Certification (LMCA):

  • Hospital Admission History and Physical report;
  • Hospital Operative report;
  • Hospital Discharge summary;
  • All diagnostic test results, including complete ECG treadmill tracings (originals or legible copies) and make, model, and serial number of implanted stents, if applicable.
  • Cardiologist report including:
  • An assessment of personal and family medical history
  • Cardiac examination and general physical examination;
  • Blood chemistry profile with fasting plasma glucose level and total cholesterol with HDL, LDL, and triglycerides;
  • A statement regarding your medication dosage and frequency of use;
  • A maximum radionuclide exercise stress test with complete tracings of the exercise portion of the test and radiographic images of the nuclear scans. (Performed no sooner than six months after the stent procedure).

AASI for Angina, Angioplasty, Bypass, CAD, Heart Attack, Stent, Atherectomy and Brachytherapy

 

After initial certification by FAA staff doctors, subsequent 3rd class renewals for the above conditions qualify for AME Assisted Special Issuance (AASI), a process that provides examiners the ability to issue an airman medical certificate to an applicant who has a medical condition that is disqualifying under 14 CFR Part 67.

 

The authorization letter received from FAA, granted in accordance with part 67 (14 CFR Part 67.401), is accompanied by attachments that specify what information the treating physician(s) must provide for the renewal issuance.
Examiners may issue renewal of an airman medical certificate if the applicant provides the following:

 

  • An authorization granted by the FAA.
  • A current status report performed within 90 days that must include all the required follow-up items and studies as listed in the authorization letter and that confirms absence of disease progression.

 

The examiner should defer renewal certification to the AMCD or Region if the airman's condition has adversely changed.

 

How and Where to Submit Medical Records to the FAA

 

 

 

08/13