DVLA publishes updated guidance on assessing fitness to drive: key changes for patients with heart valve disease
The UK Driver and Vehicle Licensing Agency (DVLA) has published updated guidance on assessing fitness to drive, including several changes relevant to people with heart valve disease and the clinicians who care for them. The revised document, released in November 2025, clarifies when medical conditions should be reported to the DVLA and when patients may continue driving.
The full guidance is available here:
Key change for aortic stenosis
One of the most important updates relates to aortic stenosis (AS).
Under the new guidance, patients with aortic stenosis who do not have symptoms of syncope (fainting) or pre-syncope may continue to drive Group 1 vehicles (cars and motorcycles) without notifying the DVLA, provided their treating clinician considers there are no symptoms likely to impair safe driving.
This is a positive change compared with previous guidance, which was more restrictive and often resulted in patients with symptomatic severe aortic stenosis being disqualified from driving.
For clinicians, the update highlights the importance of careful assessment of symptoms—particularly syncope, or pre-syncope—when advising patients about driving.
Shorter driving restrictions after valve procedures
The updated guidance also introduces shorter driving restrictions following percutaneous valve interventions.
Percutaneous valve intervention (for example transcatheter procedures):
Patients should not drive for 2 weeks after the procedure.
These timelines apply to Group 1 licence holders (cars and motorcycles) and assume there are no complications and the patient has recovered appropriately.
What this means for patients
For people living with valve disease, the updated guidance provides greater clarity and, in some cases, more flexibility around driving.
Patients should:
- Discuss driving with their cardiologist or treating clinician, particularly if they experience symptoms such as fainting, dizziness, or blackouts.
- Follow recommended recovery periods after procedures before returning to driving.
- Inform the DVLA if advised to do so by their clinician or if symptoms develop that could affect driving safety.
Advice for clinicians
Clinicians should be familiar with the updated DVLA recommendations and incorporate them into routine discussions with patients. In particular:
- Assess carefully for syncope or pre-syncope in patients with aortic stenosis
- Document symptoms and driving advice clearly
- Provide clear guidance on when patients may return to driving after procedures
Bicuspid aortic valve–associated aortopathy
The updated document also includes a dedicated section on bicuspid aortopathy:
- Patients may drive and do not need to notify the DVLA if the ascending aortic diameter is less than 5.5 cm (or less than 5.0 cm if a risk factor for aortic dissection* is present).
- Patients may continue to drive but must notify the DVLA if the ascending aortic diameter is 5.5–6.4 cm (or 5.0–5.9 cm with a risk factor). Licensing may be considered with annual review.
- Patients must not drive and must notify the DVLA if the ascending aortic diameter is 6.5 cm or greater (or 6.0 cm or greater with a risk factor). In this situation the licence will be refused or revoked.
- Relicensing may be considered after successful surgical treatment if there is no further aortic enlargement and no other disqualifying condition.
*Risk factors for aortic dissection include coarctation of the aorta, systemic hypertension, family history of aortic dissection, or documented increase in aortic diameter greater than 3 mm per year.
Guidance for Group 2 licence holders (bus and lorry drivers) is more complex, and clinicians should refer to the full document when advising individual patients.
Additional valve-related areas of note
One recommendation that remains unchanged from the 2016 guidance relates to other forms of valve disease.