My husband is 80 and a thoracic aortic aneurysm (5.7 cm) was discovered in his chest. He's had dementia for a few years and doesn't grasp what is happening. He'll require anesthesia for 2 tests prior to 6-hour surgery and post-op pain management. I'm questioning the validity of the surgery if it renders him an invalid.

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I am a retired Nurse. I will only tell you my story and my Dads. He feared and hated going to doctors all his life. Had already beat down the doctors who wanted to do prostate surgery. I took his charts to a specialist I worked with and he said it was low grade, and they were hedging; he was comfortable in it being slow grower my Dad would outlive and die of something else. Now they were telling him that he had a large Abdominal Aortic Aneurysm and were suggesting surgery. He and I were spot on frank with one another all our lives; he was in his late 80s at the time. I said "You know what Dad, tell them you are glad to know that, because when that baby blows you won't have time to know a thing". He declined surgery, died at 93 in his easy chair watching Monica Lewinsky on Larry King Live, without even a second to say "ouch".
Now all that said, he and I did speak more about options. Risks. It wasn't quite that simple. He then made his own decision (easier than making it for someone else.) Can your husband at all participate in this decision? Has your doctor explained all the risks and the many complications of blood thinners after, and etc? And make no mistake, aneurysms don't always "blow". Some do a slow leak that is painful. Some dissect which is painful. There is no guarantee that this will kill him; there is no guarantee that this will hurt him; there is no guarantee he will survive surgery; there is no guarantee surgery won't make the decisions in future all the more difficult.
I would, if you are able and they will, get the input of two good surgeons. If they won't discuss fully, don't do this. If they will you are in for a terribly hard decision which you will need to make because you MUST make it, and knowing that you cannot kick yourself later. with should-have-could-have-would-have. This is something with NO EASY ANSWER, and I am so sorry you are left making the decision. It is ever so much more difficult to make decisions for others. When I had breast cancer I refused radiation therapy. It was my decision. The cancer was already out in two nodes. That was 34 years ago, and I knew at the time I was gambling for my life, and might win, might lose. But it was me and was my decision and I was willing to accept the outcome knowing the facts.
I am so sorry you are faced with this decision. I wish you so much luck. I hope that you will update us on your decision. Do know that there is no "right or wrong" here. It is a decision that you MUST make and cannot know the outcome of.
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What Alva said.

Plus, those two tests. What two tests are they? - because I am wondering if there is possibly the third option of Watchful Waiting. How did they find the aneurysm? - is it doing anything?

I'm so sorry you're having to wrestle with this horrible set of choices.
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My MIL2 had an aortic aneurism in her late 80s, 4.5cms, and the doctors recommended not to operate because the risk of dying in the operation was about equal to the risk from the aneurism. They stopped measuring it, and we all stopped talking about it. She died aged 97. I’d certainly get a second opinion – some surgeons love operating, it’s their living.
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My husband went though this surgery at age 52.

At least one of the tests they need to sedate him for is a cardiac catheterization, so they can see if anything is going on in his valves or if there are blockages that also need to be cleared out.

You need to make sure that they know he has dementia and if he can't follow instructions with the cath. It was very important for my husband to lie very still and not raise his head afterwards and of course he did. They needed to sandbag his groin to prevent an air bubble.

Did he have a CAT scan with contrast? They might want sedation for that as well.

Are they talking about doing this surgery in a minimally invasive way?

My husband was in the Cardiac Intensive Care unit (with a chest tube) for about a day and then in a telemetry unit for another couple of days. Lots of wires. Lots of monitors. Lots of beeping.

He was home and off work for a couple of weeks and then dead tired for the next year. The surgery did not render him an invalid, but it knocked him out (no energy, no pep) for a year.

Because he has an artificial valve (rather than a cow or pig valve, which might have needed replacement after 10 years) he is on a blood thinner (warfarin) which makes it imperative that his intake of green vegetables be very consistent. He has to do a blood test each week (he does this at home; other folks go to a clinic or lab monthly) and he needs to be careful about falls and cutting hbeing.

My MIL had this surgery at 80. She survived but it advanced her dementia and she then decided to starve herself to death. She never returned home after the surgery; went from the hospital to rehab, which she refused to do and then to long term care until she passed away.

This must be a heart-rending choice for you. Don't get pressured into making this decision quickly.
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