Should an 82 year old man with CHF, CKD and diabetes get a heart stent?

Doctors can let you know what the risks are, but often cannot really predict an outcome when someone has multiple health issues. If successful, a stent may relieve his shortness of breath and give a better quality of life and/or a longer life. Or the procedure may kill him. Last week a family member in his 80s with multiple health issues, including kidney problems, had surgery against the advice of his primary doctors who had told him it was too risky. He found a surgeon who was willing to do the knee replacement and he made it through the surgery well, but then went into kidney failure during recovery and died. He knew the risks and had decided he wanted out of his knee pain - either the surgery would work and he would walk again or death would free him from the pain. Many people would say my family member made the wrong choice. I don't agree. When someone has already enjoyed a long life, I support his/her choice to risk the length of days for the chance to have more quality days. I would encourage you to make sure your father has all the information to make a fully informed choice and then support his decision. Although the decision may be difficult, I don't think there are any wrong choices here.

They will NOT do a kidney transplant in someone so old. It's simply--not done.

You have to weigh out the positives and negatives--while the stent is done under "light sedation" it isn't terribly risky. But if your dad is non compliant with the procedure's aftermath (lying still on your back for quite a long time---) could he do that?

QOL at this age is far more important than trying to "fix" all the ailments of aging as they show up.

Could you have this kind of discussion with his doctors?

In the best case, how long is Dad likely to live if nothing is done?
If it is successful, how long is Dad likely to live after a stent placement?

Then ask about quality of life in each situation. The CKD is not likely to be improved by a stent. How big is the influence of that condition on his quality of life?

My dad had the congestive heart and the beginnings of kidney problems (he later went onto dialysis) - but he had the stent put in and it helped immensely. I can remember him being so surprised that the pain was gone! He said it was the first time he could remember without chest pain.

My dad was also 82 at the time and he lived until 88 when he decided to stop the dialysis after 3+ years.

My dad is 81 and he has the same conditions and he did ,,I’m a RN and everyone is different ..I’d speak with the drs and see what they say

I certainly hope when I get to an advanced age no one is going to operate on ME. I have no one to care, so it's a moot point - except one relative. And I have expressed my wishes to receive comfort care, no heart operations, transplants, or any other tomfoolery that will extend my life for no purpose. When it's time, it's time!

Stents are often overused, because they often fail in the long run. Studies have shown that use of medications is just as good, if not better than stenting for most patients. Books I recommend to everyone are Rethinking Aging and Worried Sick both by Dr. Nortin Hadler.

IMO, cardiologists  are way too aggressive in recommending surgical options when medication is usually the safer route and just as effective. In the case of an elderly patient with so many conditions, it sounds like his doctor is being appropriately cautious. 

nikki, this is heartbreaking. Constant shortness of breath is certainly a big driving factor. I’d get 2nd and 3rd opinions. I hope others with some experience will see this. Good luck.

My Mom had one kidney working half capacity and they wouldn't do a dye test. I agree, you need a sit down with the doctors. If Dad wants it done, that is his decision.

Something else to consider is his overall conditioning. Does he exercise regularly? When my Dad was 82, he had a series of heart attacks. He also had CHF, CKD and bleeding ulcers. The docs said he needed a stent, but didn't think he'd survive long afterward.

Dad had been an exercise freak all of his life. At that point he was exercising about 45 minutes per day. Dad wanted the stent and I believed that the docs were underestimating his conditioning. Next week, Dad will be 97 years old. I attribute his longevity to his conditioning, which he keeps up to this day.