Do nothing or TAVI for aortic stenosis. My soon to be 90 mama was recently diagnosed with severe aortic stenosis. She also has some dementia, hearing loss and generally has difficulty processing information. She does volunteer twice a week which is wonderful for her and her Dr. says for her to continue with her volunteer work as long as she wishes. She lives with my husband and I. I have both financial and health Durable Power of Attorney. Her stenosis symptoms were very low blood press/pulse, swollen ankles and fatigue. She is 89 lbs. Lowering her high blood medication greatly improved symptoms. She was referred to a cardiologist and had an echocardiogram. Her regular physician provided us with the results and options, but a full report, etc. will happen when we have a meeting with the cardiologist in two weeks. The two options the cardiologist will further discuss are 1) a fairly new procedure Transutaneous Aortic Valve Insertion (TAVI) where they go through an artery in the groin (there are risks) or 2) do nothing (risk is heart attack/stroke, this is a known risk at 90 already). Because of her mild dementia and difficulty processing information she doesn't seem to recall the conversation with the Dr. and thinks all is fine now that her blood pressure is good. My heart tells me let her continue to think that - ignorance can be bliss.
She has always expressed that quality of life is most important to her and her Health Care Directive reflects those wishes. With that in mind I can't see taking her to a consultation with the cardiologist or having the TAVI procedure. I think the surgery could be successful from a cardiology standpoint, but it will take such a big toll on her physically and emotionally (depression). Discussions on the risks, preparation, fear of staying in a skilled nursing facility for a few days or worse fear of not coming home will just be so hard for her. On me too. There is more to loose than to gain. What I want is confirmation that not sharing all this with her is not only okay, but in fact is the most loving thing to do.