Aa
aortic valve stenosis
My brother-in-law is a 73 year old patient with a complicated medical history
He has had a triple bypass, has glomernephritis with a high (3.5) creatin level, emphysema (COPD) as well as pulmonary effusion, and a deteriorating neurological condition (MS or similar) so for the last 2 years he has been wheelchair bound. He is on oxygen.
His body weight is @ 145lbs -ten lbs due to water retention (height about 6 feet)
He was admitted to Delray Beach Medical Center on Saturday with Congestive heart failure and fluid around his heart and lungs. He is on quadruple lassix dosage and his kidney output has increased. They can't due a catheterization because of kidney pulmonary effusion.
Today the hospital did a test to see at what level his aortic valve was functioning. We think his aortic valve function is down to 38%-39% gradient?
They plan to do a needle aspiration of the lungs to try and determine the content of the fluid and possibly an esophageal cardiogram to check the functioning of the aortic valve.
The cardiologist does not think he would be a candidate for aortic valve replacement because of all the compicating conditions and his current weakened state. Articles we have read on line seem to indicate that an angioplasty in an older patient with stenosis is not reccommended.
What type of doctor(s) should be monitoring this patient?
What questions should we be asking ?
What direction should we be taking ?
I realize these are extensive questions and I may not have all the facts in order but any help you can provide would be greatly appreciated.
He has had a triple bypass, has glomernephritis with a high (3.5) creatin level, emphysema (COPD) as well as pulmonary effusion, and a deteriorating neurological condition (MS or similar) so for the last 2 years he has been wheelchair bound. He is on oxygen.
His body weight is @ 145lbs -ten lbs due to water retention (height about 6 feet)
He was admitted to Delray Beach Medical Center on Saturday with Congestive heart failure and fluid around his heart and lungs. He is on quadruple lassix dosage and his kidney output has increased. They can't due a catheterization because of kidney pulmonary effusion.
Today the hospital did a test to see at what level his aortic valve was functioning. We think his aortic valve function is down to 38%-39% gradient?
They plan to do a needle aspiration of the lungs to try and determine the content of the fluid and possibly an esophageal cardiogram to check the functioning of the aortic valve.
The cardiologist does not think he would be a candidate for aortic valve replacement because of all the compicating conditions and his current weakened state. Articles we have read on line seem to indicate that an angioplasty in an older patient with stenosis is not reccommended.
What type of doctor(s) should be monitoring this patient?
What questions should we be asking ?
What direction should we be taking ?
I realize these are extensive questions and I may not have all the facts in order but any help you can provide would be greatly appreciated.
Thank you for your reply. The family has decided on a wait and see for now as well
MEDICAL PROFESSIONAL
I would not recommend an aortic valvuloplasty at this point. Your brother-in-law likely needs a team of doctors to include an internist, cardiologist, nephrologist, and a pulmonary doctor.
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