Progression of aortic valve stenosis

[clacin]

My 86-year-old mother was diagnosed with aortic valve stenosis about five years ago. Her last echo showed a valve gradient of 45mm with an aortic valve area of 0.5 cm2 mitral valve area 0.46 cm2. Her last cariolite showed an estimated 28% EF. She also has hypertension and COPD. She has been experiencing shortness of breath with little exertion and has had dsypnea and syncope in the recent past. Her cardiologist has recommended valve replacement surgery but she absolutely does not want to have it.  Given this set of health issues, if she still refuses to have the surgery, how long can she be expected to live? Also what other symptoms should we be aware that would indicate worsening of her disease? Thank you.

[clacin]

Thank you so much for your response....it really gives me hope, since her cardiologist told us back in October when we asked him how long we could expect her to live if she didn't have surgery and he said at best two years....so we are encouraged by your response.  She has had three hospitalizations in the past year for pneumonia, bronchitis, and difficulty breathing at night, so we have been concerned that she would be having more and more of these types of episodes as time goes on.....is that something we should expect as the stenosis progresses?

[EchoTech]

Another option is possible.  If she absolutely doesn't want surgery, both valves can be opened by balloons passed through catheters.  The cardiologist would probably be against it as these procedures usually cause the now opened valves to leak, sometimes quite a bit. Her low EF could also by helped by ECP therapy.  The therapy ios reserved for those who have exhausted all other avenues of 'fixing' the heart disease that has presumably caused the low EF.  It has helped 'tune up' people for about a year or so.  After that they can go through the therapy again if they wish to get the same benefits again.

[Forum-M.D.-MJM]

Hello,
I am sorry to hear about your mothers heart conditions.  These are always very difficult decisions.

It is not easy to put numbers on survival, especially without seeing the patient.  In general, once people start having heart failure symptoms related to aortic stenosis, a range of 2-6 years is reasonable.  That does not mean she might not live 10 years or 2 months, it depends on many factors and is difficult to even speculate.

Also what other symptoms should we be aware that would indicate worsening of her disease?

The triad for aortic stenosis is heart failure, chest pain, and passing out. As the mitral valve narrowing progresses, she may develop more shortness of breath and possibly more hospitalizations for heart failure.

If your mom is 86 and has decided she doesn't want surgery, then she probably understands that her long term prognosis is not good.  If she understands, try to support her decision and not focus on her being sick.  I know it is hard, very hard, but try to focus on living for the now and not worrying about the future.

Good luck.  Thanks for posting.