FAA Guide for AMEs
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Third-Class AME Assisted
Valve Replacement
This AASI for AMEs is presently restricted to the issue of a third-class airman medical certificate. First- and second-class applicants must be deferred to the FAA.
AMEs may reissue an airman medical certificate, if the applicant provides the following:
- An Authorization granted by the FAA;
- A current status report performed within the past 90 days in accordance with the CHD Protocol;
- A current 2D echocardiogram performed within 90 days; and
- For Mechanical Heart Values - A minimum of monthly International Normalized Ratio (INR) results for the immediate prior six months.
- The airman requires another valve procedure;
- Evidence of perivalvular leaking via echocardiogram;
- The post procedure valve area is less than 1.0 cm2
- New onset arrhythmia such as of atrial fibrillation/flutter, ventricular bigeminy, ventricular tachycardia, Mobitz Type II or greater AV block, complete heart block, RBBB, LBBB or LVH;
- More than 20% of INR values are less than 2.0 or greater than 3.0; or
- The pilot or controller reports any other disqualifying medical condition or undergoes therapy not previously reported.
AME Assisted Special Issuance (AASI) is a process whereby the FAA delegates to AMEs the ability to re-issue an airman medical certificate under the provisions of an Authorization for Special Issuance of a Medical Certificate (Authorization) to an applicant who has a medical condition that is disqualifying under Title 14 of the Code of Federal Regulations (14 CFR) part 67.
A staff FAA physician provides the initial certification decision and grants the Authorization in accordance with 14 CFR § 67.401. The Authorization letter is accompanied by attachments that specify the information that treating physician(s) must provide for the re-issuance determination. If this is a first time issuance of an Authorization for the disease/condition, and the applicant has all of the requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or RFS for the initial determination.