My Grandma died with congestive heart failure after Valve repair surgery

[Robb73]

I am in need of answers for my own peace of mind.My grandma died 8-2-2005 2 weeks after valve repair surgery, she was 77 years old and active until 1 year ago.she started having swollen ankles and legs she was given lasix and the swelling would get better, then worse. They said she had chronic broncitis she was never a smoker, then in may of this year she started getting tired a lot which was not like her, then in june she passed outwhen we were out,she was taken to the er, told she had CHF and a leaky valve, the cardiologist set up a cardiac cath test,the day we took her,they could not do it, because her lungs had so much fluid in them she was admitted when the test was done they said she needed the valve repair surgery or she would be dead with in 6 months, beacuse the valve was that bad. right after the surgery doc said she only had a 50/50 chance of surviving the night,he said when they opened her up the right side of her heart was much weaker than then thought.days after surgery she seemed better, some drips were off, she was aware,the vent could not come off then they put in a pacemaker then she was ok for days,then her kidneys stopped working, she went on constant dialysis then the drips had to be raised to the full amount and her bp was still only 90/60, she got sepsis, her blood was not clotting & her gut& liver were not working,they said at that point it was a matter of time and they took her off the vent and drips she died in 20 minutes. Does all this sound right,At the end was there really no hope? Should she have had the surgery would she have died soon with it

[MinnieM]

My sincere condolences to the loss of your grandmother.  My Mother also died at the age of 77. They would not do surgery on her as they said she most likely would not survive.  So either way, Mother was in trouble. We too felt guilty but guilt is normal with any medical decision one has to make for a loved one.  The key now is to make sure other family members are checked on a regular basis for this or any heart condition and earlier intervention if needed.
God Bless.

[Robb73]

CCF-M.D.-MJM
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
Thanks again for the answers

[Robb73]

Thanks so much for the comments, kind words and encouragement. It is really appreciated. It has been hard and she was a wondeful woman. I was always closer to her than my own mother and my 2 sons were closer to her than any of the other grandparents or great grandparents, even my wife says nobody loved the children like we do except her. She did leave a nice legacy and I will try and focus on the good memories and good times. I also believe that where ever she is she is still looking out for all of us, like she did when she was alive.
Thanks Again

[Robb73]

Thank you for your quick reply I really appreciate it. It has been hard to deal with her death, but your answers really have helped me with the what ifs, I kept thinking she would have lived with out the surgery, even though her doctor said the 6 months would have been terrible for her, she would have been bedridden, not been able to walk and would have kept filling up with fluid. She would not have wanted that she was always very active. I will try and find out which valves were replaced if I can, I guess she was much sicker than everyone thought and she was not one to complain, her friends blame her primary, but in all fairness he did send her to different docs with her initial symptoms, but like i said she never liked to complain even in the icu before she died she would nod and gesture that she was ok. I did forget to mention that one of the doctors feels she may have had rheumatic fever when she was a child and if that was the case to live to her age and have the active life she had is fantastic. Also she always had high blood pressures and was on meds for it, then in the hospital even before the surgery it was low is that normal?
Thanks Again for the answers.

[EchoTech]

Unfortunately, yes these things happen.  In the end, when her organs started to shut down, it becomes a complicated spiral that is hard to get out of.  As for the timing of the surgery, I don't know all the details, so I can't give you a good idea on that.  At the facility that I work at, they try to "tune up" the person as much as posssible if they can before surgery.  They usually wait for the person to be stabilized, but if she had a very bad valve that got worse very quick, then they probably did the right thing.  I'm sorry for your losss and hope this helps a little bit.

[Robb73]

Thanks for the kind words. Yes she was an extremely strong woman and you are right even at the end she pushed her self, she used to love watching by sons and my little one turned 3 in June, the ast year before he got sick, she used to love taking him on the senior citizen bus with her friends and they would go shopping. My wife is a teacher and this year went back to work full time, my oldest is 7, and mama (my grandma) was telling us in the hospital that she had talked her friend who she was going to pay to take her in the afternoon to pick up the kids up so we did not have to worry, she was a special lady, I just want to know that everything went the way it was supposed to go, i keep thinking I could have done soemthing different and she caould still be here.
Thanks again

[PJmomrunner]

I'm so sorry for your loss.  It is so difficult to lose someone you love.  It sounds like your grandma's condition was pretty dire going into surgery.  At 77 she'd probably been thinking her body had been slowing down for years and just pushed through it like the strong woman it sounds like she was.  Again, I am very sorry for you.  Hang on to your memories of her and she will live on in your heart.

[CCF-M.D.-MJM]

Hello Rob,

I am very sorry for your loss.  From your very detailed description, I can tell you that your grandmother was very sick.  We almost never see people recover from multi organ failure like you described.

Regarding the second question, I think what you are asking me is should she have had the surgery.  I am not sure which valve was replaced, based on her age and the symptoms you describe, I am guessing she had either aortic stenosis or aortic regurgitation, the syncope is a common symptom of advanced aortic stenosis and a very poor prognostic sign.  When aortic stenosis advances to the point of heart failure and syncope, it is a very dangerous situation that requires surgery or almost certain death in 6 months to a year.  It does sound like she needed surgery.

Even with our very best efforts, there are still people that present late with these disease processes or have unexpected complications.  From the description you provided and with me making a few assumptions about what was going on based on  her age and likelihood of what was wrong, it sounds like surgery was the only option for cure or life sustaining improvement.

Your feelings of guilt are normal.  I know this doesn't make it any easier, but it does get easier with time.  Your love for your grand mother is clear and I wish you and your family the very best in these times.