Under BasicMed, could a pilot who has had a cardiac valve replacement operate legally?

• A. Yes, with a one-time Special Issuance FAA medical certificate
• B. Yes, automatically with BasicMed no extra action
• C. No, BasicMed forbids any prior cardiac surgery
• D. Only if the replacement is less than 1 year old

Answer: (A)

Having a prosthetic heart valve is a significant cardiovascular history that often needs formal FAA medical review rather than a routine BasicMed evaluation. BasicMed relies on a physician-cleared status, but certain conditions—like valve replacement—usually require the FAA to grant a Special Issuance after a thorough review. This is because the valve and any related treatments (such as anticoagulation) carry risks that must be carefully managed and monitored.

So, the way to fly legally in this situation is to obtain a one-time Special Issuance FAA medical certificate. The FAA would evaluate your condition, treatment plan, and follow-up requirements with your treating cardiologist or an Aviation Medical Examiner, and, if approved, you’d fly under the FAA medical certificate under whatever conditions and renewals the Special Issuance specifies. BasicMed alone wouldn’t automatically allow operation after valve replacement; the Special Issuance pathway is the official route to reestablish medical eligibility when this history is involved.