Pilots returning to flight status after coronary artery bypass graft surgery

Pilots are the most important asset of the aviation industry, and and their coronary artery disease endangers aviation safety. The aim of this study was to get acquainted with the conditions of pilots returning to flight status after coronary artery bypass graft surgery.

A comprehensive review of databases for the studies was conducted until the end of 2019. Also, a review of aviation medical regulations and of instructions of specialized books on aerospace medicine was performed.

Military pilots are rarely able to return to flight after coronary artery bypass graft surgery. On the otherhand, in the case of civilian pilots, at the end of six months of successful rehabilitation, those who were asymptomatic with ejection fraction≥50% in echocardiography, normal exercise tolerance test, no inducible ischemia in stress echocardiography or myocardial perfusion imaging, no arrhythmias in holter monitoring, and acceptable blood biochemistry tests, can return to the flight with a restriction of flighting with presence of more than one pilot with no medical restrictions as well as regular annual medical examinations. Otherwise, they will be unqualified forever from the flight.

From the age of 40, pilots have a higher incidence of asymptomatic coronary artery disease, sudden cardiac death from arrhythmias, and thromboembolic events than normal population. Young military pilots are in better conditions in personal and organizational health monitoring. But, unfortunately, if they had coronary artery bypass graft surgery, due to disability after surgery and side effects of prescribed drugs, they would have very little chancec of returing to the flight.