Open Heart Surgery & Memory Loss

[Picasso222]

My 70 year old husband has been diagnosed with the following:
1) atrial fibrilation
2) several mitral regurgitation
3) left ventricle enlarged 6 cm
4) left atrium enlarged 4.9 cm
5) moderate to severe aortic insufficiency
6) mild tricuspid regurgitation
We have seen a heart surgeon who wants to perform these procedures:
Biological bentall
Mitro valve repair or replacement
Cox Maze procedure to correct atrial fibrilation
Open heart bypass
My husband has had mild short term memory loss for about five years and his primary care physician is advising against the surgery telling me he will never be the same again.  This is the most difficult decision either of us has ever had to make and we are being torn in two different directions, especially because my brother-in-law had open heart surgery 6 years ago and has not spoken a word since the operation.  What would be my husband's prognosis if he does not have the surgery and what are the chances of further memory loss if he does?  I might add that he is not overweight and does not have other health problems such as diabetes, etc.

[Lee Kirksey, MD]

Hello
Im sure that this is a difficult time for you. As youre aware, your husband's condition is very complex. It seems that your concern and the concern of your physician is memory impairment following surgery

It is impossible for me to describe your husbands prognosis just from looking at his test results. The physical examination of a patient is frequently the most important tool that physicians use and the evolution of medical illness over time is another important variable.

As surgeons, when we determine the need for surgery-generally we weigh the risks of not treating the problem vs the risk of surgery. When the risk of not treating the medical condition exceeds the risk of surgery; we proceed


In your husbands case, I would request a second opinion with a cardiologist and cardiac surgeonl. Gather your records and make an appt to have your husband evaluated at the nearest center of excellence for heart surgery. As a surgeon, when patients are uncertain about proceeding with surgery, I encourage asecond opinion. It is good to reinforce the level of comfort

It is always your option to refuse surgery and instead to proceed with the best medical therapy

Good luck

[Paladon]

You don't mention if your husband is suffering any health issues because of his condition. I would suspect he is suffering shortness of breath. If he's not suffering any health issues I would forgo the surgery, diagnosis or discovery is no reason for surgery if no problems are experienced. But yes, I have been experiencing memory loss since my valve repair surgery, and I have discovered I am not alone in this, and he too would probably experience it also. It's a hard decission. I don't remember being forwarned of it, it could have been in print but I just skimmed and signed, but I needed to have the surgery so it was not like it was a choice. I would have had the surgery even if I had been forwarned. My quality of life has improved. My memory loss seems to just have been manefesting for the past year or two, and my surgery was in August of 2005. I am just now learning that it could have been from the surgery. And I am now trying to get on a solution for it. Good luck to you both, and if he has the surgery I hope he gets the quality of life improvement he should.

[DPease]

The comments from the MD on the first line are correct.  An assumption is being made that you have not seen a Cardiologist or at least have not received a second opinion from one.?  Being diagnosed with an atrial fibrilation etc would suggest tests performed by a Cardiologist or a GP that actually cares and referred.  It is not common practice (should be) but Medicare and Private Insurance pays for whats called a Cardiac Event Monitor.  Gp's and Cardiologists are able to prescribe this to your husband.  It has the ability to catch close to 100% of any event your husband has.  It can give a more accurate diagnosis than a 12 Lead EKG done in the office which normally catches less than 5%.  It is worn for up to 30 days and allows for communication to a live representative at a lab.  I understand you have already being diagnosed but how?  You can research these devices online, there are numerous studies showing its benefits... The next question should be, "What is my treatment plan"?  If there isn't a CLEAR concise answer to this question you need to get a second opinion.  You should already be on a treatment plan! Good Luck!
Signed, concerend and trying to educate the general public...

[Picasso222]

Thank you very much, Paladon.  I really appreciate your taking the time to write a very helpful note.  We're going to a neurologist tomorrow with results of recent cat scan and one from 2 years ago to see if there has been much change in his memory.  Then will schedule a second opinion with cardiologist.  Thank you again.

[Picasso222]

Thank you very much for your advice.  We are definitely going to check into getting a cardiac event monitor.  He's also going to get a second opinion, but are leaning towards a non surgical approach.  Thanks again for your very helpful note.

[copaitza]

Realy?