One must select surgical candidates very carefully, and advanced age is definitely an added risk. But there’s a lot of good meta-data out there that shows that advanced age alone does not mean bad outcomes, if other indicators are favorable.
Now, I’ve seen over-optimistic physicians who push treatments on people who are too old and ill to be good candidates for said treatments. And I’ve seen such treatments end up with poor outcomes. And I’ve been outraged myself by seeing unneeded procedures such as screening colonoscopies pushed on 90 year olds with life expectancies less than 3 years, to name only one such situation.
But most hospitals these days that are doing such higher risk procedures as valve jobs are requiring risk-benefit analysis before allowing such a procedure to take place. So it’s not completely unreasonable to assume that the proposed surgery does make sense. And I’m okay assuming that, since the OP is not asking us if he should have the procedure.
I had a valve repair recently and it was supposed to be the less invasive type where they come in from the side. They had problems with it and plan-B was the full chest cracking procedure. So basically I’ve had both at the same time.
The less invasive method may be a smaller scar but it was by far the most painful part of recovery. It still surprises me sometimes when I’m bending around and that’s 6 months after the surgery.
Regardless of which method used the patient will have to choose between a mechanical valve and biological valve. As stated above the mechanical valve lasts longer but it requires continuous medication and constant monitoring. Forever.
recovery time for me was a week in the hospital and a week with a care giver before I could care for myself and that was an additional month at home plus rehab. The hardest part of recovery was the weakness from surgery (during the day). I would get fatigued walking 30 feet. Pain wasn’t a problem during the day so I didn’t take the full amount of pain killer but at night it was a different story. Every time I moved it hurt like hell. Much worse than kidney stones. There’s no real way of getting out of bed without lifting yourself up and you’re not supposed to lift or push more than 10 lbs because that stresses everything in your chest.
The medical people can chime in and verify this but the fatigue is due to the anesthesia and that is harder to deal with as people age.
Sorry to give you a huge article for the cite. Here is the relevant paragraph:
“A big advantage of the transcatheter aortic valve procedure for aortic stenosis over traditional surgery is of course recovery time. In general the activity limitation is dependent upon the access site in the leg. Patients typically sit up a few hours after the procedure, and can walk some the same day. The day after we have patients working with the physical therapist. A few days precaution regarding heavy lifting may be advised. But in general there are no other specific limitations after the procedure.”
My uncle in California had something like a quadruple bypass a couple of months before he turned 92 and made a full recovery. Turns 97 next week and still travels and plays golf. So it happens.
I believe so. I was lucky and didn’t need a valve replacement or any bypasses. but this type of operation requires the heart to be stopped so the patient is on a heart/lung machine. There is more than one anesthesiologist in the operating room. It took longer than I thought. I was off work for 8 weeks.
The surgeon told me 1/2 day less. I asked him why it took a week and he said to ask him again after the surgery. I think I was there a day longer than expected. They were obsessed with water retention in the lungs and IMO got a little carried away with the diuretics.
that’s very interesting. It only talks about the aortic valve and not the other 3. It also looks experimental and not available for low risk patients. It is definitely less traumatic than the low invasive procedure I started out to get which is what I thought you were referring to.
Reading through the link it has it’s own risks which is why it’s still being done on a limited basis but the op’s father may qualify (assuming it’s an aortic valve replacement).
I had my AVR (not TAVR) less than a year ago, and talked to the surgeon and the cardiologist about this. They are saying this is pretty much routine now, doing it for lower-risk patients is more and more accepted. The surgeon said that when my bio-valve wears out in 15 years or so, this is the procedure they will most probably use to replace it.
Thanks for that. I try to provide accurate info, and try to control for my own inherent subconscious biases.
But don’t take that assertion about cardiac surgery and the elderly as a blanket approval of any/all medical procedures recommended for the elderly, or for anyone for that matter. While certain higher risk procedures now get more scrutiny than they used to before being given the go-ahead, there are still a lot of practitioners who believe that the particular procedures they do are good for nearly everyone. Asking questions, getting 2nd opinions, and doing one’s own homework is always appropriate.
My father goes in for his catheterization today, to determine if there are blocks in his arteries and veins. This is preliminary before the valve replacement, which will be scheduled in the coming weeks. He should be home tonight, so I presume this is a relatively minor procedure (although I went home the day of my lumpectomy, so who knows.)
My 88 yo mother had bypass surgery earlier this year and is doing quite well! (for an 89 yo, that is.) She was in a rehab facility for a week before coming home. Lots of family in the area and we made sure she walked and generally moved around. Had a visiting nurse a 3 times a week to help with bathing and the like but was driving after 5 or 6 weeks.
A positive attitude is your father’s best medicine
Good news…no blocks. I didn’t know they did this procedure while you were awake. He had to lie completely still for three hours afterward. That must have been tedious.
Next up, the valve replacement, which will probably take a few days to set up.
My 93-year-old grandmother had a valve replacement recently. She was extremely weak for the first few days afterward, but now she’s doing better than she was before the procedure. It is certainly scary, but there is hope! Keep us posted!