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Return to flying after mechanical arctic valve replacement?
I have been out of flying for 18yrs. I left with my 3rd class medical and a private complex ticket. I currently am on Warfin and have had no issues. I am a police officer still and also pass my commercial drivers license medical every year. Anyone have advice on attempting to get my 3rd class medical back? I have an appointment with a new Cardiologist in June and would like to be prepared. I have all my surgical notes and pervious test. Any advice would be great. New Member and I look forward to flying again!
49 Replies
My advice having been in a similar situation, is to make sure you are dealing with someone very competent with the FAA. You're local AME may not be that person. I started going down that route but quickly learned that it would be like pounding sand since the AME didn't have time to coordinate with all the other specialists that the FAA requires input from. And those specialists (like perhaps your cardiologist) aren't familiar with the FAA.

The solution for me was to go to the Mayo Clinic in Rochester, MN. They have a department dedicated to dealing with complex aviation medical issues and they do a fantastic job. Also, they are so well respected that the FAA looks to them for guidance as well. Even just calling those guys up and having them look at your records without a visit would be very worthwhile. They will let you know what you're up against.

Whatever you do, DO NOT expect the FAA to be of ANY assistance in getting your 3rd class.
I had an aortic aneurysm repaired 2 years ago (no heart damage, NO heart attack, just some plumbing repaired)  I've had total release with NO limitations from my surgeon, my cardiologist, and my Primary Care.  I sent all this information as well as the hospital records (ALL of them) to the FAA (Atlanta Aeromedical office).  I was soon advised that I would not be qualified to be granted any level medical for flight.  I had both my cardio thoracic surgeon and cardiologist CALL the FAA medical examiner (wanna be doctor that drives a desk) to no avail.
Do I sound bitter ---- I guess so!
I've gone through all the processes, done everything the FAA asked me to do.  I call and asked the AOPA for assistance that I paid extra for --- it was worthless.
The only thing the FAA wants now is for me to go through tests that I already have successfully accomplished and from which I sent them the results.  These tests would costs over $25000 and still would not guarantee me a medical certificate. Even my Surgeon and cardiologist think that they're crazy as the FAA already has copies of all these tests I took and passed with flying colors.
It seems that their job is to keep older pilots (I'm 63) out of the air at anytime they can.  I'm a commercial instrument pilot and was ready to take my CFI practical but the FAA decided that the system didn't need a 30+ year experienced Pilot as a CFI or a charter pilot.  (Never had an accident, never broke a FAR,  Owned and flew a PA-32-300).  Well I'm done!  I sold the Cherokee 6 (full adsb and IFR compliant with a mid-time engine) and watched my plane disappear over the horizon with my desire to fly.
The FAA's Aeromedical Division needs to be totally dissolved and rebuilt from the ground up (no pun intended).  They have non-medical personnel making decisions and the medical personnel they have making decisions don't have the ability to be medical doctors. …...don't even mention common sense!
How can a "physician" that drives a desk have the same ability and decision making capability as a Harvard educated Cardio-Thoracic surgeon that's the director of the heart program for a major hospital  and a highly regarded Cardiologist with 30 years experience?
Be careful as you move forward...…………….do NOT volunteer ANY information to the FAA!  They'll use it against you.

Dale Sanders
Memphis, TN
Hi Marc,

I only follow this forum intermittently, but I noticed your post and since I am a Senior Aviation Medical Examiner (AME), I thought I would respond to your inquiry.

It will take extra work and time (probably months), but it may be possible for you to re-establish your Third Class Medical Certificate.  It will require a "Special Issuance" by the FAA.  You will still need to start by completing your Medical Certificate application on-line at  (notice no "e" between the "d" and "x").  Be thorough and honest as you fill out the application.  When you submit it, you will receive a confirmation number.  This will be valid for 60 days.  Next, you can make an appointment with an AME of your choice.  If you think it will take more than 60 days, you may want to make the appointment first, then do your MedXpress application within the 60 day timeframe beforehand.  If you need help finding an AME in your area, you can go to  When you see the AME, provide him/her with your MedXpress confirmation number.  He/she will access your file and provide additional details of his/her examination findings.  You need to know that the AME will not be able to approve your application him/herself.  He/she will have to "defer" your application to the FAA.  The final decision on your application will be made by the FAA.  Initially, they will send you a certified letter acknowledging that you saw the AME and that your condition (regardless of what it is) does not meet their qualification standards BUT the letter will go on to describe what specific steps you can take to pursue a "Special Issuance".  The "Special Issuance" requirements vary by condition but all are very specific.  

A resource regularly used by AMEs, but available to the public is the FAA Guide for Medical Examiners.  This can be found at  Of course, it is geared for AMEs rather than a layperson, so much of the language is professional in nature.  At the top of the page is a search box.  You can type valve replacement into that box and it will take you to another page called Decision Considerations - Disease Protocols.  From there, choose the Cardiac Valve Replacement (PDF) hyperlink.  Alternatively, here is the direct link to that page

Having this information will be helpful when you go to see the cardiologist as it outlines exactly what the FAA will be looking for including guidelines for the warfarin medication you mention (an INR of 2.0-3.0 is a general goal).  The FAA can be very picky about what information they want and how they receive it, so be sure to follow the guidelines exactly.

The overall process can be tedious and frustrating, but patience and persistence will hopefully pay off in the end.

David B. Greer, MD, FAAFP, DABFM, Senior AME-EE
Excellent thought process... work thru the details before jumping back in.
May I suggest that you schedule an "interview" with your chosen AME?
DO NOT put any data into until after the interview.
DO print the forms in medexpress and fill in what you think is the data they
are asking for and take those forms to the AME.  The AME will likely suggest
changes to the way the data is presented.  If the AME thinks you will pass a medical,
then make those changes and go back to that AME for your medical.
This will likely cost you twice... you should pay for the interview, and it will likely
cost that same as the actual AME exam.  This is fair... you are using the AME's
time and expertise.  What you are saving yourself is the nightmare of failing
an FAA medical exam and the requirements for more data for them to give you
a waiver.   Go for it!  I have several "rusty pilots" come back and successfully
pass their FAA medical, or know that they should not apply for it.

Jer/ "Flight instruction and mountain flying are my vocations!"
- - - 
Jer/ (Slash) Eberhard, Mountain Flying Aviation, LTD, Ft Collins, CO
CFII Airplane&Glider, FAA-DEN FAASTeam Representative
Good advice regarding the initial "interview" AME consultation.  I forgot to include that thought as I was composing my response.

David B. Greer, MD, FAAFP, DABFM, Senior AME-EE