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Hi all. My relatively healthy mother has been advised by the ER cardiologist to have a heart valve replacement. There was an article last year in the NY Times that this operation is expensive and causes other problems especially in the very old. Any experience with this?

Her symptoms are difficulty breathing, weakness in her arms and fingers, raspy throat.

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She's 95. Is it worth it to put her through this? I can't imagine I would want this if I lived to be 95. I can't imagine I'll live to 95. Hope not.....
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My father is 94, recent diagnosis of multiple myaloma, our first reaction was hospice let him go. Dr. convinced us to not leave him in and pain and to do radiation and very light chemo, well it has worked very well out of pain mostly. BUT just because a medical treatment is available should you? A Dr. is usually going to push for the treatment, but now looking at my father I am not sure that was best. Seven weeks in the hospital now very weak and his comment to me was 'I should have just died" I would do a lot of research.
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Judda, I often look at things in the light of "what is the worse that can happen?" In this case Mom might die! At 95 her time is limited anyway and she herself wants to do this so encourage her. Yes there will be recovery but it will be minimally invasive probably little worse that the catheter test she has on Tuesday. I would not say the same about open heart surgery where there would be a long painful recovery. This may give her a few more years of comfortable activity and independence.
Anyway listen to Mom not me I roll up into a ball of anxiety with every procedure and insist on general anesthesia for everything.

Is it risky?
Of course everything is?
Is Mom in reasonably good health for her age?
Sounds as though she is.
Is she competent to make this decision?
Sounds as though she is?
Does it matter what her PCP thinks?
No he is not a cardiac surgeon and you don't trust him anyway.
What is your greatest fear?
Of course loosing Mom no getting round that but right now she needs your support.

Now I am just going to pull a blanket over my head and try not to think about having to face something similar in the future.
Make a cup of tea first and watch the humming birds at the feeder. Distraction, it works wonders.
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My initial reaction was like a lot of the others here, why would a 95 year even consider such a thing? The literature implies the new procedure is fairly simple with excellent outcomes, but you might want to push the doctor for honest answers to a few quality of life questions... beyond prolonging life how will she benefit, what happens and how soon if she doesn't have it done.
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I have a friend who had this exact procedure at the age of 72. She was in very very bad shape...I'd say she was more like an 85 year old in terms of health, strength, and ability. After the operation, which was fast and uneventful, she felt like a new person. She could finally breathe, didn't struggle walking to the bathroom, had more energy, clarity of mind. She said to me...why didn't they offer this to me years ago??

I think because of the type of operation it is, and the fact that she is generally healthy other than the symptoms caused by a bad valve that it may be worth the surgery. She may, like my friend, feel like she has a new lease on life.

You should talk to the doctor and make sure you take his advice. Ask specifically about the type and amount of anesthesia and how this can be minimized as I would think this would be the riskiest part of the procedure.

Angel
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Hi All. Never was a question in Mom's mind: operation or die and no she "isn't ready yet" for that. Meanwhile I learned that my dentist has a 97 year old patient that just had that operation and is doing great now, just a few months later. I think Mom can make it.
njny: Your Mom is exactly like Mom and you and I feel the same way. Bring on OUR counselors for the next decade!

Mom has befriended the managers where she lives at the Indep Living Senior apts. There are new managers there and I met with them and Mom today. The women explained to me Mom's financial status at the Coolidge and we discussed ways to look at how Mom will pay for the TAVR operation. They pointed us to SHINE to learn about insurance options and how to find out the total estimate from the hospital after Tuesday, when they do the important test with a catheter to see if veins are blocked.

Funny moment today: sitting in the office with the managers, Mom kept interrupting me and putting me down. They wanted me to continue talking. "Well! why doesn't somebody tell me to just shut up?" she asked, trying to sound ambiguously amused and also challenging us.

"Very well, " said the manager. "Shut up and let your daughter talk."

The assistant to the manager, Julie, offered to take Mom to the appt on Tuesday and even to stay with her for a few hours. I have to work so I was mega relieved. Plus Mom is tons nicer to anyone but me and even if she is nutso with fear, she'll at least won't be mean because I won't be there for her to scapegoat on. I'll get her later in the afternoon, if it's possible.

Tomorrow we visit her primary doctor, who I can't stand. So I'll have to bite my tongue while we hear what he thinks. Usually he flatters Mom and allows himself to be manipulated by her. I go as the third, unwanted wheel, asking intelligent questions which annoy them both!
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It doesn't take much of a brain to slow down and think over all the parts of this "non-invasive" (yeah, right) operation. Too many idiots are far too willing to submit themselves to the Medical profession and eager insurance companies rather than take the time to figure out things, get a second opinion and talk to her insurance company to avoid financial ruin, and invite God Knows What new opportunities to be sicker than learning alternatives. Or even to accept one's mortality. Our culture is sick itself. What is death? a step over a threshold: no big deal. We have done it millions of lifetimes before!
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I did a web search for the latest info and all in all found a consensus that "Transcatheter Aortic Valve Replacement Is Safe, Effective for Very Elderly Patients". here is a link, hope you can access it before it is removed
health.clevelandclinic.org/2014/10/tavr-procedure-safe-for-elderly-with-aortic-stenosis/
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Judda, what are the recommendations of her cardiologist? has she seen him/her, beyond being advised by an ER physician?

If not, that's the first step. She/he would know what other co-morbidity issues there are and what the best chances of survival and recovery are.

Frankly, I wouldn't rely that much on newspaper articles, even if the reporter was reliable. Reporters aren't medical people; they don't have access to someone's medical records, and they can't make judgments or projections. They can report generally but I'd look to your mother's treating physicians for guidance on survivability.
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Judda, people like your mother with a strong will often can overcome obstacles that others might not. I think so much of any challenge is mindset, and if your mother is determined, that's a major part of the battle right there.
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