Your post could have been written about me, and I am almost to the 4 year mark.
I have had a ICD installed, and I receive dialysis 6 days a week, and my quality of life is pretty good, considering where I was almost 4 years ago. I am able to do all of my own shopping, housework, cooking, etc, and still have enough energy to hike into my favorite fishing hole and spend the rest of the day. However, I am 20 years younger than the patient you're talking about.
My EF in the beginning was 15-20%, and my prognosis was not good. I was told I was going to die by several different doctors, but I have proved all of them wrong. I haven't seen my cardiologist since the implantation, but I believe my EF has improved, and my kidney failure is also improved, just from the way I feel, and what I'm able to do. My next scheduled visit is in June, and for the first time I'm actually looking forward to going.
My point is, there are several things the doctors can do to help your patient, if they will do it. Medication, implants, special diet, and giving him the recipe for life, which includes no smoking, no alcohol, restricted sodium intake, and as much excercise as the patient can handle without labored breathing. The bottom line is, the patient has to take the recipe and work at making it a lifestyle. Once the lifestyle is in place, then I believe the doctors will do the rest because the patient is willing to try to help themself.
I hope the best for you and your patient......
It is difficult to say how much is the life expectancy with EF 20% , as it depends upon other factors also like functioning ability of the heart, any blockages in the vessels of the heart, response to the medication given, any risk factors like smoking, alcohol and level of physical activity etc.
As, you are having MS, the degree of stenosis also plays a role in prognosis. Due to severe MSA pulmonary edema and generalized edema and shortness of breath are common. With drugs and life style changes symptomatic relief can be achieved. If the stenosis is severe then surgical approach should be considered. Best.