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Hello,
Looking for some good opinions, not guarantees.
My dad is 78, has been in great health until the Spring, when he just wasn't feeling good. End up he went into the hospital in late September for a week with Congestive Heart Failure. They took 19 lbs worth of fluid out, did all the imaginable heart tests and bottom line his heart is working at 25%. They sent him home and his hospital cardiologist said he would need to have an aortic heart valve replacement. He's stubborn, and refused any surgery so they gave him meds to keep the fluids down, but now a month later he is filling back up and has come to the conclusion that to have a chance to live normal again he must have the surgery. He's just scared of dying on the table. There are no other issues medically other than this problem. We've researched other good cardiologists for a second opinion, and they all agree. I have found one of the best cardiothoracic surgeons in Florida to perform any procedure.
All that said, I have done a lot of research on the subject and found other than direct open heart surgery there are other less invasive procedures as well. We will find out from the surgeon which one he is a candidate for.
Essentially, we're all scared. I would like to hear from an experienced cardio physician, or surgeon what he may be facing. Most of all, since this is all new to us and we have talked to all those people who have an opinion "Oh, it's just routine now, he'll be fine" I'd like to hear a professional opinion about the risks of surgery, what MOST prognosis's are in getting through the surgery (If you can use just basic percentages please), and what he can expect (In general) for the next 5 years or so it would be greatly appreciated. I know knee surgery can be risky...and I am not underestimating this of course. That said, how successful is it in one, making it off the table from what you have seen, and two how will this surgery help him feel? I can tell you now from his heart being so damaged he is just tired all the time and it can't pump enough to keep the fluid out. Can we expect, if all goes well that an 85% heart rate is feasible afterwards?
If you wish, for a longer reply can be sent to my email address. Thanks for any help.

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Bill Clinton avoided another heart attack by going vegetarian or vegan. Drugs are dangerous. Food is better, at any age, and a lot more fun! The heart valve operation is not an option and open heart surgery is not viable. Mom is ready to tweak her diet and meet Dr. Taylor.

She and I had a lovely weekend.

Take care of yourself everyone.
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I just want to add that I don't expect my mother to reverse her heart disease but at least she can learn some, make some changes, and when she goes, at least in won't be on the operating table, or in a nursing home with a demented mind.
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Thanks everyone for your discussion about how to have an opinion bout heart surgery. Yikes. She'll be 95 June 4th! I just hope the counsel of Dr. T will help her relax, clean the arteries as much as possible. I heard that you can reverse heart disease in as little as 2 weeks by switching to a completely unprocessed, all plant diet. There is so much online to get rid of most diseases. It's time caregivers consider these methods rather than break the bank, get people in huge debt, and not even cure the disease because the cause of disease is never addressed. So much to learn!
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Good news, i think!
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HappyGal this may be by far the best option for Mom. You may even find that she is actually relieved she can't have the surgery. All things considered if she had it there would be at least a years recovery from open heart surgery so in her position I would consider that a year I had squandered. I have already decided that should I need open heart surgery i would not waste that precious year recovering. Don't know what I would decide about minimally invasive.
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Hi. Well it turned out that Mom can't have the lesser evil: the heart valve replacement surgery because her arteries are too narrowed. Now they say her only option is open heart surgery!! And the hospital didn't know if they could find someone willing to try operating on a 95 year old. So, I called my Functional Medicine ND, and Mom and I are going to work together to make dietary changes and she AND I will improve our hearts and our figures!
It took some doing but she's willing. I have positive feelings about this plan. We'll let you know what happens. By the way, HappyGal is JuddhaBuddhaBoo but my account was all screwed up.
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Happy Gal I don't think anyone can predict how much improvement there would be after a heart valve replacement. assuming the surgery is survivable at the very least it will stop things getting worse.
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I wouldn't say that Dick Cheney "has no mental impairment"! ha
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50schild. Tex has many years experience as an ICU nurse so she can tell you just what happens to patients after cardiac surgery. Post on her wall and she can answer a lot of questions. My advice is to go to a cardiac center where several cardiac proceedures are completed every day and ask what their mortality rate is. I am advised that the open chest method is prefered by sugeons because it gives them a better visual field to work in. Rather than asking the surgeon what his sucess rate is ask how many of these he has done, at least 50 would be nice. Like everything else there is a learning curve and you don't want to be at the begining of that. Any surgery has risks as they will tell you and there can be unexpected things happen in the healthiest of patients, during and after the surgery. But you have to think of the alternatives which in your case and the other questioners would probably involve calling hospice. In both your cases the surgeons feel there will be a good outcome.I also second the advise to start anti depressents at least two weeks ahead of the surgery because they can take that long to become effective and it will help calm the patient's fears. An experienced surgeon will not work with an inexperienced team in a substandard facility so you can expect the OR team and the post op nursing to be of the highest standard which will greatly reduce the risk of infections. The patient has to be prepared to do their part too by co-operating after the surgery and doing all the exercises both in hospital and after discharge. As others have said it is a long painful recovery. I don't know what the quality of life will be but if you look at Dick Cheney as an example he looks pretty fit and healthy with no mental impairment. He was also on that external pump for quite a while awaiting his transplant and was well enough to be interviewed on TV. Good Luck for both surgeries and please share your experiences
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My 82-year-old husband is pending open heart valve replacement with two bypasses. He also has severe multi-level lumbar stenosis, but otherwise is in decent health. Yesterday two surgeons rejected him for TAVR because he was not frail. Both surgeons, at a respected research university hospital, felt my husband would recover as well as any 50-60 year old. They did not promise anything, but since my husband has had two TIA's (mini-strokes), they felt the minimally invasive TAVR would put him more at risk for stroke. Also with TAVR, they do not removed the old aortic valve, which can cause poor fit of the new valve and blood regurgitation and other problems. They affirmed that open heart is the "gold standard." Even though the hospital, like most, were chomping at the bit to get him into a TAVR study -- they could not approve it. What frightens us is that their opinion was that my husband might leave the hospital as early as 7-8 days past surgery, whereas I read that hospitalization for an 82-year-old is more usually 2 weeks. We had a bad experience with rotator cuff repair surgery, where before surgery, the surgeon believed it would be somewhat of a quick recovery. The truth was, after surgery (outpatient), recovery was brutal. Brutal is the only word I can use. The pain pump wasn't working and we didn't know it. We had poor instructions for in-home care. The incision became infected and we were coldly told to "go to any emergency room." After two week's at home, swelling of his arm and leg were quite severe, and we were again told to "go to any emergency room." So we are scared and wary, too. Texarkana, do surgeons (from highly respected research hospitals) routinely make surgery sound easier and less risky than it really is? How can I best watch out for my husband? Babalou, where do you find success rates of surgeons? I have scoured all "non-fee-based" services and a few "fee-based" services, but this information appears to be secret. To outright ask, "What is your success rate?" appears to bring back talkative responses, with a final disclaimer that nobody can guarantee an outcome, and it is up to us. Susky, I feel your fright. I would never forgive myself if I ignorantly went positive with professional opinion, yet my husband came out of it with dementia. It has us frozen, and putting off surgery though we were told we should NOT wait two months as his symptoms are getting worse quickly. So far, he has no heart damage. Any comments appreciated. Nurses know a lot and especially nurses can give some inside opinions, as Texarkana has done. Babylou and Musiclover, thank you so much for sharing what you have been through. We just don't know if we are being Pollyanna in believing the two surgeons' opinions, or not. You both went through unexpected challenges and heartaches. What would you do different?
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My mother at an otherwise healthy 82 had her aortic valve replaced due to aortic stenosis. They also did a triple bypass. They opened her chest and she made it through. Her recovery was a nightmare. Her lungs were compromised and too weak to maintain normal breathing. Her carbon dioxide a month out of surgery elevated to a very serious 113. She was rushed back to hospital and put on a ventilator with a trach. She contracted every hospital acquired infection out there. Had to have a peg feeding tube for months. But today she is 88 and living with me and is off the ventilator. She is doing very well but will always need a trach due to scar tissue. I stayed at the hospital for three months and took leave from my job. Every person is different. But my mom was told by cardiologist consider the surgery and don't wait two years when it would be in an emergency situation. My mom was scared too. She had a sister die during heart procedure. But I told her this was her decision but as her advocate I was going to ensure she made an informed decision. So I bought her a book on aortic valve replacement and showed her a video. I am proud of her to this day. It took 18 months and constant chronic care/hospitalizations/ rehab before she could finally be released. God bless you and your father.
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I am a retired nurse, used to work in the heart transplant ICU.I will be blunt. There is no such thing as a routine surgery.,and there are no guarntees. The percentages you are quoting I believe are based on what is called an ejection fraction,basically measures how well the heart works as a pump. An ejection fraction greater than 55% is considered normal, no such thing as an 85%.Besides the actual surgery itself is the risk of general anesthesia on an already sick heart,I have seen many times a patient die just being put to sleep, I don't mean to scare you but this is serious surgery.I feel for you, you have a big decision to make.It's a gamble.Now of course I have also seen successful valve replacements with an increase of quality of life.He would probably have to be on a blood thinner afterward and that brings complications of its own.You are asking good questions but you need to direct them toward the surgeon who will bedoing the actually surgery.Also just go on line and type in the very questions you are asking here.Cardiac surgery has come a long way but again there are no guarantees.Also the effects of anesthesia have to be taken into consideration.I have seen surgeries cancelled because cardiology wouldn't clear the patient for anesthesia,didn't think their heart could take it. If you can get a second opinion great.But if you are looking for statistics , go on line and just type in what are the survivial rates for a male with the type of problem your father has and I am sure there will be a ton of info that pops up.The 25% you mentioned I will take that that is his ejection fraction.That isn't good, in fact I am surprised he doesn't pass out when he tries to sit up or stand up.You have some hard decisions ahead,arm yourself with info, it is at your fingertips with the internet these days. But realistically, no one can guarantee a good outcome.This kind of surgery would be risky for a younger person. Again, there is no such thing as routine or minor surgery.
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I'm not a doctor, but my husband had aortic valve replacement (also his whole aorta) and my mil had the same surgery two years ago. The main enemy here is anesthesia. If they can do a minimally invasive procedure without cracking his chest, recovery will be easier. In my experience, surgeons don't do elective procedures on folks they think are going to die on the table.

Research individual surgeons and what their personal success rate is for this surgery. You also want the hospital with the best nursing. That's what gets you through recovery and out the door to rehab.

Pick your cardiac rehab facility beforehand. Find a place that specializes in cardiovascular if you can and tour it with your dad so he'll be familiar with it. Let him see the exercise machines and have staff talk with him about what kind of treatment plans they usually device for post op patients. The more expected and familiar he is with what is going to happen, the less fearful he'll be.

Recovery from heart surgery is always a slow process. The protocol for most cardiac surgeries is to put the patient on antidepressants afterwards. My husband agreed, and I think it made a big difference in his recovery. You might find out if the doctor recommends your dad start them now rather than wait. Good luck!
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