Mitral or Aortic Insufficiency : Further FAA Medical Workup
AASI Protocol Instructions for Airman and AME
Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide page 264, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).
AME Assisted Special Issuance (AASI) is a process that provides Examiners 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.
An 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 application for an AASI for either mitral or aortic valvular insufficiency, and the applicant has all the requisite medical information necessary for a determination, the AME must defer and submit all of the documentation to the AMCD or the Regional Flight Surgeon for the initial determination.
AMEs may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
- An Authorization granted by the FAA;
- A summary of the applicant's medical condition since the last FAA medical examination, including a statement regarding any further episodes of atrial fibrillation; and
- A current 2-D echocardiogram with Doppler performed within last 90 days.
The AME must defer to the AMCD or Region if:
- The mean gradient across the valve reaches 40 mm HG;
- New symptoms occur;
- An arrhythmia develops; or
- The treating physician or Examiner reports the murmur is now moderate to severe (Grade III or IV).
This page discussed Mitral or Aortic Insufficiency : Further FAA Medical Workup
Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now