Aortic valve Stenosis

Hi,

My grandfather is 94 years old with a strong will to live and still enjoys a good joke. He is wheelchair bound and pretty weak. He has 70% Stenosis on his Aortic Valve and he is on Lasix and Digoxin.

His Doctor claims that without surgery he has approx. 6 months to live.The Doctor claims that this surgery has a 80/20 chance of success. The doctor wants to perform an angiogram as a first step. How risky is that? Is Valvuloplasty a less risky option?

Do We have any other options ?

Thank you

[Cleveland Clinic]

chaim

Its a difficult question. As we have the ability to grow older many people find themselves in this type of situation.

The main options you have are medical therapy, bypass and valvuloplasty.  Without knowing all of the details I can;t make specific recommendations.

The fact that your grandfather is in his 90s is certainly a risk in itself. The weakness and wheelchair however, sound like the biggest redflags in terms of overall risk. He would have a very hard time recovering from surgery.

Valvuloplasty is pallitive, meaning it can decrease symptoms and lead to a better quality of life, but the underlying valve is still damaged.

An angiogram in itself carrries about 1/1000 risk of a serious complication in good hands. The main risk for your grandfather would be stroke, heartattack, and kidney problems.

It's difficult making the right decisions for our loved ones. I would have a serious sit down with your grandfather and find out exactly what he wants. Alot of time, when you explain in detail what surgery involves (ventilation, sternotomy, pain issues, recovery issues) alot of elders decide not to go with the risk.

Either way, you should clarify end of life decisions prior to undertaking any care of this nature.

Good luck

[Chaim]

Thank you very much.