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A few more questions about grandmother' valve surgery and death after surgery
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Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

A few more questions about grandmother' valve surgery and death after surgery

by Robb73, Nov 14, 2005 12:00AM
Tags: Heart, Life, years
I posted here on 10-6-2005 about my grandmother's surgery & her death 2 weeks after it I have a few more questions, i hope that is ok, I looked on the medicare billing paperwork and here is what it says for the surgery:

1 repair of mitral valve

1 valvuloplasty, tricuspid

1 insert ia percut device

I know now that the surgery was the only hope, I just wish it would have turned out differently. Also she always had high blood pressure but once she got to the hospital, her blood pressure was low even the week before surgery. what does that mean? Also they had said that when they went into do the surgery, the right side of her heart was very weak and that the doc. did not know that till he did the surgery is that normal not to know ahead of time even with all the tests? They said that the weak right side of the heart is why she never got better after the surgery. I wonder why they pushed the surgery and not just let her have 6 more months? a doc thinks she may have had rhematic fever as a child & that her heart may have been bad for a long time. does that make sense? Should her primary have realized all her heart problems sooner? The multi organ failure after the surgery in the ICU was that caused by being in ICU so long? I keep thinking maybe if she had stayed on life support longer she may have gotten better;everyone says no and that the fact that she died 20 min. after it was removed means that even with life support the end was close. Thanks in advance for answers,I miss her so much & still having hard time with this & just want to be clear on all the medical question
Doctor's Answer

by Cleveland Clinic, Nov 14, 2005 12:00AM
Robb73,



These are really impossible questions to answer. It is clear that your grandmothers surgery carried some risk. It is impossible to say what would have happened if she wouldn not have had the surgery, but looking at your original and this post, her corse would have probably have escalated and she would have probably suffered from further cardiac symptoms.



I can tell you are still hung up on a lot of the details. I would suggest you sit down and discuss the case with your grandmothers physician who can perhaps put this more in persepctive and answer the details for your questions.  It is impossible to speak without generalization here, but the overall picture I have from your post is your grandmother lived a long life, with many happy memories which is why you miss her so much.  Your focus on the surgical descision was made with the best hope and outcome in mind, but sometimes that is just not the case. You didn't kill her by undertaking a surgery or withdrawing life support, and the quality of life she would have had even in that situation is questionable.



The greiveing process is a difficult one. You will always have some questions. If you continue to get hung up, or cant get over these details perhaps some grief counseling may be of help.



good luck



Member Comments (16)

by Robb73, Nov 14, 2005 12:00AM
To: CCF-M.D.-bkj
Thanks for the reply, I guess I should stop focusing on the details. I doubt her doctor would talk to me now, but I have to talked to enough medical doctors, nurses etc, and everyone seems to say the same thing, so I guess I just need to accept what happened and how, but that is the difficult part.....

by Konopka1955, Nov 14, 2005 12:00AM
Hi Robb,  I'm sorry to hear about your grandmother passing away.  You asked if it was possible to have had rheumatic fever and not know about it. I can say for me - it was - I had a heart attack many years ago and yet until they went in for my mitral valve surgery just last year - no one (including myself) knew that I had ever had rheumatic fever.  The surgeon said it was definently scarred from rheumatic fever.  So in my case and perhaps your grandmother as well.  I don't know for sure.  But up until I was 49 years old I had never been told I had it and previous to my surgery I had many cardiac 'tests' and catherizations over the past 10 years.  I do remember my surgeon saying - he wouldn't know for sure how badly my mitral valve was damaged until they went 'in' and looked at it - they had hoped they could do a repair - but it was so badly scared - I needed a mechanical one..  Then right after surgery I went into "Full Heart Block" (electrical) and I know that was unexpected.  But it does happen.  I guess (I'm guessing) its hard to know 'exactly' the condition of the entire heart until they get in there.  Even then I wouldn't think they would know for sure - how the heart will react to the surgery.  Especially as we get older.  Its even more of an impact to have open heart surgery - I would think.  I think each case is 'different' and I'm not a doctor.  But as a heart patient - I can tell you - I agreed to have surgery and take those chances - because I knew I could not have survived at all without taking the risk and I do remember the surgeon went into great details about all the possibilities of problems during surgery - as any heart surgery is very risky.  Then again without it - I really think I would not be alive today.  



Please take care

Konopka





by Robb73, Nov 15, 2005 12:00AM
To: Konopka
Thanks for your reply. That took a load of my mind! The doctor said that considering when she must have gotten rhematic fever, it was a miracle that she lived to 77, most people at that time died in their 50's. Thanks again for taking the time to post. It really helped!

by Cheryl M, Nov 15, 2005 12:00AM
I am sorry for your loss , I was were you are 9 years ago when my grandmother passed away ..When they came out and told us they needed the familys permission to remove the respirator , that basically she might get better but the next time she got sick it would only be worse on her  yet still I was the only one who said "no" ....



when I walked into her room and I looked at how frail she was and how weak she was , she was 83 and a fighter and I figured if she couldnt fight anymore then there was nothing anyone could do, so finally I agreed and they lowered the b/p meds and highered the morphine drip and she went into cardio-pulmonary arrest and died peacefully .



Yes I was stingy in wanting to keep her and yes I thought that the Dr's could have done this or that , but even the smartest doctors or the best medicine can only be so life saving and there are times things have progressed to a point that you have to let go and that is the hardest thing to do !





brightest blessings in your time of need

by Robb73, Nov 16, 2005 12:00AM
To: Cheryl M
Thanks! It is nice to know I am not alone in having gone through this. Somedays I feel that I am ok and other days a much harder and I still keep playing what if!

Thanks again for the support

by kpacey, Nov 26, 2005 12:00AM
To: Robb
Robb, my 45 yo brother recently had surgery to repair his tri-cuspid valve, which no one knows why it was damaged.  It could have been from a viral infection years ago, caused by diet pills, etc.  All seemed to go according to plan until a few days later when his heart stopped.  Like you I went looking for answers and consumed myself with thoughts of "what if".  The fact is, it's not always like we see on TV.  People really do die and we just have to accept it and move on.  I'm not saying it's easy as it's taken me 3 years to let go.  All I do now is think of all the good times we had together and how lucky I was to have him in my life for the time we had.



kp



by mydad, Dec 01, 2005 12:00AM
I have a very painful, sad story to tell.  My dad was diagnosed with mitral valve prolapse five years ago when he was 68. Five years later at age 73, his cardiologist told him his condition was much worse and should undergo valve repair/replacement.  He was shocked and distraught.  He had hardly any symptoms, but was told that if he did nothing, he would have a major heart problem in five years.  He elected to have the surgery with my mom's and my encouragement to do it sooner than later.  Two weeks before Thanksgiving he had the surgery.  There were extreme complications after the replacement because of his extensive calcifications.  He had one leak after another, four redo's of emergency surgery.  Twelve hours of surgery, and his heart gave out and he passed away.  My mother and I were in shock.  We were told there was a 5% mortality rate.  We are still in shock.  What were these doctors thinking?  He may have had problems to come, but he would be alive and maybe he would have lived for awhile.  

We spent Thanksgiving without him and can't believe this surgery