Flying Waivers for History of Angioplasty and Myocardial Infraction.

Abstract : Angioplasty has become common for the treatment of significant coronary disease (SCAD). In many cases an aeromedically significant lesion (50% or greater stenosis) may be dilated to less than 50%, raising the question of whether these patients could be considered under minimal coronary artery disease (MCAD) criteria, and allowed to fly. Suitability of MCAD to fly is based on a study of ACS patients with 20-40% lesions, who had a annual cardiac event rate of 0.6%. An extensive literature review by AOC presented at ASMA in May 1994 showed that the lowest cardiac event rate, after one year following successful angioplasty, was 2.4% per year with no subsequent decline. A lesion classified as SCAD which is subsequently dilated to less than 50% cannot be considered to be equivalent to MCAD. The Aeromedical Consult Service recommends that aviators who require angioplasty be permanently disqualified from all classes of flying duties.