Advice?

[HRH]

I am writing on behalf of my 77 yr old Father. Dad has Severe Aortic Stenosis and is currently waiting for an admissions date to have his aortic valve replaced (tissue) in the next couple of months. He is symptomatic.

He is terrified, but understands this is his best option. Having said that, during quiet moments we still can't help wonder if it is worth it at his age... even though we know it is:eek2:

We would appreciate your views given you have all been through the experience.

 

[epstns]

I really don't know how to approach this question. I am 63 and had surgery earlier this year. There was never any question in my mind which path was right for me.

How is your dad's health otherwise? How about his spirits and attitude? Does his family have a history of longevity?

I'll admit that although the surgery is not "rough" for the patient (he will be under anesthesia and won't feel or remember any of it), the recovery was a bit rough. If dad is a relatively average to tough guy, he probably can manage recovery without trauma. If he is very frail, I would consult with all of his doctors before making any decisions. (Even if he is very frail, there may be other surgical options such as the TAVI, in which a valve is inserted by way of a catheter through an artery, without conventional open surgery. There are several US hospitals now participating in the trials.)

In any event, the conventional professional opinions seem to agree that even at your dad's age, valve replacement surgery is a viable option, absent other life-threatening co-morbidities. In other words, if he is otherwise healthy (age adjusted), then they would say he could proceed with surgery.

I guess it may be an "attitude" thing -- but my question would be "Is there any reason NOT to go ahead?" After a couple of months of recovery, dad could have some pretty good years ahead of him.

Keep watch on this thread. I'm sure some others, more experienced than I, will be along shortly.

 

[HRH]

Thanks for responding, interesting. Dad has a positive attitude, and I wouldn't describe his health as frail. He's medicated for BP & cholesterol, and prone to chest infections following a cold. His Father lived into his 90s.

I asked the surgeon about TAVI. Eligibility strict on our NHS and he doesn't meet the criteria. I worry if he'll survive the op, and the post op complications. He's been given a 4% risk to his life and 10% risk of complications.

To complicate matters further, he has been asked to take part in a study. The aim is to try a new technique for cutting the breastbone called a mini-sternotomy. We're still looking into this...

 

[tprice54]

Waiting to go into the OR, the man next to me was a 83 year old vet, still practicing part time. 2 days later we were walking the floor together on the step down unit, and he couldn't wait to get back to the animals.....so, it definetly depends on the attitude going in.

 

[Jkm7]

If your Dad's health is otherwise reasonably good, it is definitely worth his having the surgery. Being on blood pressure and cholesterol meds is very common and not a detriment to his likelihood for a successful surgery. Many people here are on similar meds.
I would strongly suggest he discuss having a tissue valve vs. mechanical so he won't have to deal with coumadin and at his age, a valve likely to last up to 20 years, would be a good choice if his doctors agree.

Mini-sternotomy is quite common in the U.S. and many members here on VR.org have had their surgeries that way. A smaller incision is good.

I personally know of two people who had valve replacement surgery in their eighties and did absolutely fine. They are enjoying these years with their family and friends and have no regrets having had the surgery.

All best wishes to your Dad and your and your family.

 

[escargome]

HRH,
My opinion is have your dad go for it. He will be fine. In my personal circumstance I wish my mom had been able to avail herself of valve replacement, but alas it was not to be and she passed away at 78 from congestive heart failure.

 

[Bina]

Barbara Walters did very well, and we all know that she is no Spring chicken

 

[Adrienne]

I had an aunt that had an aortic valve replacement in her late 80's. She lived (and WORKED as an interior designer) until 95, and her death was not related to her valve.

 

[Mentu]

H, one of the neat things about Cardiac Rehab is that you meet a lot of people who had surgery about the same time you did. In my group our oldest member was an 80 year old. In our Rehab group she started out slow and steady but by week 6 she was leaving several of the younger people in the dust. Before her valve replacement Mrs O. had come to think that life was pretty much over for her. After surgery, it did take her a few weeks more to be ready for Rehab but by the time we finished our twelve weeks she was planning on taking a trip to someplace warm with drinks under little umbrellas. The valve replacement made as much difference in her life as for many people much younger than her.

Larry

 

[HRH]

Thank you all for your comments, we have found them most helpful. Dad is going for a tissue valve, and is also keen to try the Mini-sternotomy trial. It is reassuring to know there are people out there Dad's age and older who have survived and benefited from AVR surgery. We have to take the view he is fortunate to be considered viable for this op.