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FAA CACI Mitral Valve Repair Worksheet

Pilots who had mitral valve repair can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. It applies when the repair was done 5 or more years ago for primary mitral valve disease. The AME reviews the treating cardiologist's progress note from a visit within 90 days of the exam and the most recent echocardiogram, then issues if every criterion is met.

Who completes it

The AME completes the checklist and marks the Block 60 outcome. The treating cardiologist writes the current, detailed Clinical Progress Note and supplies the most recent echo report the AME checks.

Submitting and payment

How to submit it
A qualifying case is noted as 'CACI qualified Mitral Valve Repair' in Block 60 of FAA Form 8500-8. If any item is not met, the AME defers and submits the supporting documents to the FAA.

Good to know

  • Repair for secondary or functional mitral regurgitation from coronary disease, MI, ischemia or cardiomyopathy does not qualify. If any valve other than the mitral was involved, the case goes to the FAA.
  • The echo must be within 24 months and show no more than mild mitral regurgitation, no aortic regurgitation, no aorta over 4 cm, no left atrial enlargement and no cardiomyopathy.
  • The pilot must have no connective tissue disorder such as Marfan or Ehlers-Danlos, no moderate or worse COPD or pulmonary hypertension, and no other cardiac disease.
  • Anticoagulation is not routinely needed; if warfarin or another anticoagulant other than aspirin is required, the AME defers. An annual echo is not required for each exam.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Mitral Valve Repair Worksheet

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

How long after mitral valve repair can a pilot use the CACI?

The repair must have been done 5 or more years ago, for primary mitral valve disease. Before then, or for secondary or functional regurgitation, the AME cannot issue under this worksheet and the case goes to the FAA. The cardiologist's note must also confirm the pilot is asymptomatic, stable and needs only routine annual follow-up.

Does the mitral valve repair CACI need a new echo every year?

No. The worksheet states an annual echo is not required for each FAA exam. The most recent echo must be within the last 24 months and show mitral regurgitation, if any, as mild, with no other abnormalities such as aortic regurgitation, a dilated aorta over 4 cm or left atrial enlargement.