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I agree with jeannegibbs completely. My mom is almost 80 with dementia, and there's no way I'd let her go under general anesthesia now. My dad had general anesthesia at 71, to put a shunt in to drain water off his brain. He "disappeared" on us almost overnight.  He had general anesthesia again at 74 for a hip replacement, and that's when he died, while still recovering from surgery in the hospital. 

Plus I also agree that cardiologists, and any kind of specialists, are frequently focused exclusively on their specialty. They do not always see or process the "whole picture." I've actually found that many specialists in general are very uninformed about dementia. If your MIL has a GP, I'd definitely recommend talking with him or her, and if you haven't already, get MIL a referral to geriatric psych before you make any decisions about general anesthesia.
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She's 89 years old and has dementia? Ain't no way I'd go along with surgery for her. Ask the doctor what alternatives there are to relieve symptoms.

Does she have a different specialist who manages her dementia? A neurologist or geriatric psychiatrist? If so, I'd discuss this with them.

Cardiologists focus on fixing hearts. That is their life mission. I don't blame this doctor for recommending this "solution." But I think you need to take a broader view with a goal of maintaining quality of life and dignity for MIL. Many doctors, especially geriatricians, do have this broad view. It doesn't seem to me that this cardiologist does.

I highly recommend the book "Being Mortal" for a very insightful look at what matters most at the end of life.
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