calcification of the abdominal aorta

I am asking quetions for my 82 year old mother who has CHF and also has one kidney.  She has a blocked femoral artery and angioplasty was attempted but when the surgeon went in he found the abdominal aorta to be 80-90% blocked due to calcification.  She was given the options to treat it medically, place a "Y" stent(though surgeon had little hope for this because of the extent the stents could be expanded due to the calcification, and finally bypass surgery.

Any advise on this matter and any new procedures for such a diagnosis?  Should bypass be the only option, how risky is this for a patient of this nature?

Any information would be so appreciated.


This discussion is related to Calcification.

[kenkeith]

Jane,
To answer your E-mail.  I was dx'd with CHF 3/04 after experiencing two nights of mild pulmonary edema (dry cough, choking, smothering sensation...sitting up provided relief) CHF, enlarged left ventricle, 98% blocked RCA was stented, LAD completely blocked but collateral vessels provided a natural bypass, and circumflex 72% blocked was not stented, MVR, slightly elevated blood pressure and a fast heart rate.

Medication is an ACE inhibitor to reduce the heart's workload by dilating vessels, beta blocker (coreg) to help reduce workload, baby aspirin and sometimes a nitrate (for angina) prior to going to the gym to exercise on the treadmill and some resistance training.  After leaving ER I was taking a diuretic and plavix for a year.  I am noton a special diet, my weight has always been acceptable and no family history of heart disorders.

I am not in any stage of heart failure as meds have reduced an enlarged LV, increased my EF to normal.  For the last 4 years, I have been very well, no problems whatsoever.  Recently, I was put on lipitor to reduce lipid levels, and the med effect has met the desired lipid levels.

You may find interesting the COURAGE study that had an objective to compare meds, stent and bypass treatment for CAD.  The conclusion by a statiscal analysis show no significant difference among the compared treatment for a patient's longivity. Yes, surgeons often resist doing major surgery on an individual over 80 as the risk of complication outway the potential benefit.

I have a non-interventional cardiologist and he states he would recommend EECP if I begin to experence angina that can not be controlled with medication.  EECP treatment is non-intervention and very little risk if any and it is an  accepted procedure with medicare coverage for heart failure and CAD.You can google EECP for the specifics and talk to your mother's doctor if the procedure could be of benefit to your mother's condition.


  

[anna4969]

Thank you so much for your reply.  I did google the EECP and that appears to be very optomistic.  However, I worry about this part of the article:

But not everyone can have it. People probably should not have EECP if they have certain types of valvular heart disease (especially aortic insufficiency), or if they have had a recent cardiac catheterization, an irregular heart rhythm, severe hypertension, significant blockages in the leg arteries, or a history of deep venous thrombosis (blood clots in the legs). For anyone else, however, the procedure appears to be quite safe.

My sweet mother has the irregular heart rhythm(thus the pacemaker), moderate hypertension and a significant, 95% blockage in the femoral artery.  So given that I wonder if this would be an option.  However, in my mind, it certainly is worth an inquiry on our part at her next Heart Failure Clinic appt. in June.  

I so appreciate your advice.  I did also send you a private message about her that is far more in depth than the history I provided above.  And hoped you could comment on those issues.

My mom has so many issues Kenkeith that I almost feel sorry for her cardiologist, hemotologist, nephrologist, and enderologist,  They are always dealing with a very fine line and balancing her drugs just so.  However, inspite of all of her MAJOR issues, she is absolutely determined to live and combat these issues as best she can.  I just hate what I know and am always extremely worried about when the next finding comes about.

Anyway, thank you for your response and I would so appreciate your advice on the other post to you directly.

Jane