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MandyMV

MandyMV

Well-known member
Joined
Mar 2, 2008
Messages
46
Location
Maryland
Hello Everyone,
I got a call last night that my grandmother is in the hospital with early stages of CHF. She is 92 years old but very active and in relatively good health. She had trouble breathing this weekend and everyone finally convinced her to go to the ER where they admitted her. Unfortunately, she is the only one who has talked to the doctors so we are not 100% clear on what is going on. She told us they think her aortic valve is closing (didn't say why) and they are going to try medicine for the next 4 days to see if it helps and if that doesn't work they want to do OHS to replace the valve. When I find out more I will post but wanted to see if anyone knew of people having surgery at this age and if it is more about overall health then how old you are?
Cheers,
Theresa
 
I can't say that I have. I don't want to say she's too old, but I would have to ask if heart surgery is going to improve her quality of life. For her, that would be the issue. I'm just not sure it's worth the risk in this case. I'm sorry, I'm not trying to sound like the major bummer drummer, but I have doubts.

See if there is any way you can find out from her Doctors just what's going on. If she has CHF, chances are great that there is already significant heart damage involved.
 
There's no such thing as being too old these days.It very much depends on the general health of the individual and weighing up the benefits of surgery against the risks.I hope your Gran gets well.
 
You may want to read this, it's medical speak, but gives you the best information I can find as a whole article:

http://circ.ahajournals.org/cgi/content/full/102/suppl_3/III-70

Conclusions—Functional outcome after aortic valve replacement in patients >80 years old is excellent, the operative risk is acceptable, and the late survival rate is good. Surgery should not be withheld from the elderly on the basis of age alone.
 
One one the early Heart Surgeon Pioneers had his own procedure performed on him in his [edit] late 90's and lived another [edit] 2 years after that.

The Doctors were divided on what to do until his wife insisted they operate as I recall. He came through OK but did have a lengthy recovery.

I've forgotten his name and details, but there was an article posted about it somewhere in the VR.com archives.
[edit - it was Dr. Debakey]

As others have indicated, overall health and Benefit vs. Risk are the primary factors in deciding on a course of action.

'AL Capshaw'
 
I think alot would depend on her overall health beside her heart, I think IF they decided she really needs an AVR I would ask about the percutaneous valve trials.
 
At age 92, life expectance has been exceeded by more than a decade. Quality of life, both hers and the "caregivers" has to be considered. Sure, with modern technology, she can probably survive the surgery....but then what?

Someone will come along with the story of one of the pioneering heart surgeons, I think it was Dr. Debackey(?) who underwent OHS at age 97 and survived... but only two more years(?). If you read the entire article, the cost of his care "easily exceeded one million dollars ...and this cost was borne by the hospitals and doctors invoved. It was never filed against insurance(Medicare) and can you imagen the level of care that this mans peers would have provided him.

Unfortunately I've seen this in my own family....and its tough, VERY tough, on the whole family.

My feeling is that the "risk/reward" has to be carefully weighed.
 
Last edited:
Hi. My 82 year old grandmother had a heart attack in November. She has Parkinson's Disease, and the cardiologist flat out told us he would not do OHS (bypass) surgery on her. They did 2 caths & she's on many meds, but the card said at this point in her life, it is about quality of life, not quantity of days. While she was recovering in the hospital one of her roommates was a spry old lady, 91 years old, who was headed in for OHS (again, this was bypass surgery, not valves). But her health was much better, and although she was older in years, was going to have surgery.
Best wishes to your grandmother, I'll keep you all in my prayers.
 
ALCapshaw2 said:
One one the early Heart Surgeon Pioneers had his own procedure performed on him in his early 90's and lived another 7? years after that.

The Doctors were divided on what to do until his wife insisted they operate as I recall. He came through OK but did have a lengthy recovery.

I've forgotten his name and details, but there was an article posted about it somewhere in the VR.com archives.

As others have indicated, overall health and Benefit vs. Risk are the primary factors in deciding on a course of action.

'AL Capshaw'
Click to expand...

It was Dr. Michael DeBakey heart surgery pioneer and master surgeon from Houston. I have read all the details. He actually had a dissecting aneuysm of the aorta , very painful. I think at that age I would just like them to put me to sleep- though that is not done in our system. Mike had a rough post-op course, but did pull through. An entire chapter is devoted to him in Sherwin Nulands book THE ART OF AGING, for any one who wishes to explore the details and philosphy on this issue. He was 97 at the time of his operation and almost made it to 100. The final conclusion is that age does not directly relate to survival rate.
 
dick0236 said:
At age 92, life expectance has been exceeded by more than a decade. Quality of life, both hers and the "caregivers" has to be considered. Sure, with modern technology, she can probably survive the surgery....but then what?

Someone will come along with the story of one of the pioneering heart surgeons, I think it was Dr. Debackey(?) who underwent OHS at age 97 and survived... but only two more years(?). If you read the entire article, the cost of his care "easily exceeded one million dollars ...and this cost was borne by the hospitals and doctors invoved. It was never filed against insurance(Medicare) and can you imagen the level of care that this mans peers would have provided him.

Unfortunately I've seen this in my own family....and its tough, VERY tough, on the whole family.

My feeling is that the "risk/reward" has to be carefully weighed.
Click to expand...

Yes, it was Dr. Debakey who pioneered Coronary Artery Bypass Surgery, the use of Dacron Conduits for Aorta repair / replacement, and did early work on an artificial heart.

He died in 2008 at the age of 99. Unfortunately the Google Link to his story is "no longer available". I did see a comment about surgery in 2006 so apparently he only lived for 2 more years. I'll see if I can get any more details.

'AL Capshaw'
 
Mandy,

I spoke with a former CardioThoracic Surgery Nurse.

Her advice was to have your grandmother evaluated at a Major Heart Hospital by a Surgeon with lots of surgical experience with elderly patients.

It would help to know where your Grandmother lives and what hospital she is in. If she is in Maryland, Johns Hopkins is probably the best of the nearby hospitals.

A 'local hospital' that focuses mostly on ByPass Surgery probably would not have a great deal of experience doing AVR on elderly patients.

'AL Capshaw'
 
I notice you are located in Maryland. You might want to check with Dr. Bavaria at the University of Pennsylvania. He is currently one of the doctors doing valve replacement through cathertization. He was my doctor for my open heart surgery and he told me how only does the cathertization method with the elderly usually 80 years old and up. He is a great surgeon. Hope this helps.
 
lucky401 said:
I notice you are located in Maryland. You might want to check with Dr. Bavaria at the University of Pennsylvania. He is currently one of the doctors doing valve replacement through cathertization. He was my doctor for my open heart surgery and he told me how only does the cathertization method with the elderly usually 80 years old and up. He is a great surgeon. Hope this helps.
Click to expand...


They are a great team, Justin goes to CHOP but his adult chd doc is HUP and it's kind of one big team.
 
Thank you everyone. You have put me at ease and now I am in action mode! My gram and dad are in Barnegat, NJ (1 hr from Philly) I just talked to them and unfortunately the doctor hasn't been in yet with any update but they had suggested she go to Deborah Heart and Lung Center in NJ if she needs surgery. Does anyone have any experience here?

I also mentioned to my Dad that Dr. Barvaria was suggested by my forum friends. Lo and behold he is my dad's cardiologist!! Crazy. I told him to call him and see what he says about the situation.

My Gram is a very independent, Italian woman who doesn't like to be sick so my only worry with OHS would be her mental state of needing help and pushing herself too much during recovery. I would love it if they could do it through a cath! Oh and 92 sounds old but her sister is 96 and her Mom live to 99 1/2 (she didn't want to have Willard Scott announce that she was 100 on air-very proud)!

Again thank you for the advice and encouragement.
 
You have great genes, Mandy. :)

Good your Dad will call his excellent cardiologist and get his opinion.

This is a huge surgery for such a senior person to endure. Even those of us many years younger and otherwise healthy take up to a year for full recovery. There are some here who think they are still recovering more than a year post op.

Good luck for your Gram.
Please let us know what decisions are made.
Aside from wishing you well, I think it an interesting case.
 
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