heart surgery for 77 years old-mitral valve stenosis and repair for it

May 13, 2014 5:43 PM

I have a feeling that hospitals push surgery all the time. my grandma was diagnosed with a heart defect that she was born with and they recommended surgery for 40 years.she has mitral stenosis and she was fine and on meds and no major issue except once when she was in the hospital. however now that we revisited the subject, I asked her if she should get the surgery. she is 77. she is saying God forbid that old people have trouble recoviering from it and that she can die from a surgery when she can just live as long as she can naturally and the pills help her. we know that the pills only treat the symptoms not the underlymg cause. so from your experience and with your old beloved, how do they handle heart surgery after 75? did you have good or bad experience with such surgery? of course I will just respect her wish but I wonder what experience did you have with your beloved ones undergoing mitral stenosis surgery
posted by barexamfreak to Health & Fitness (6 answers total)

My grandmother had a mitral valve replacement a few years younger than that. It made a huge improvement in what she could physically do, it added years to her life. Unfortunately, she developed dementia a few years later, after treatment for rectal cancer, so it is hard to say what would have happened if she had not had other health issues. She passed away at age 84.
posted by kellyblah at 6:08 PM on May 13, 2014

It's a total YMMV situation. I have a old (literally) friend who had valve replacement surgery in his mid-70s and it's given him 5+ good years (so far).

My Dad is 81 and had triple-bypass surgery about 5 years ago. More or less ditto - he's having some different health issues now, but the surgery was a success.
posted by randomkeystrike at 6:46 PM on May 13, 2014

My grandfather had valve replacement surgery - I want to say when he was in his 70s but he may even have been in his early 80s. It was a success - he lived to be 92 and was quite active to the end.
posted by SisterHavana at 9:08 PM on May 13, 2014

Ask the doctor if she is a candidate for percutaneous aortic valve replacement. This is a procedure in which valve repair is done through a catheter instead of open heart surgery. You may have to be referred to a different surgeon who is trained in this relatively new procedure.

Open heart surgery is no trivial thing for the elderly even though is it commonly done these days. There is a significant risk of serious complications or death. It is not a decision to be taken lightly.
posted by JackFlash at 9:52 PM on May 13, 2014

It's not just about age. What matters more is what your grandma's health is like. I've seen heart surgery done on strapping 93-year-olds who did great. I've also seen surgeons decline to perform surgery on people far younger because their overall health status was far too poor to be likely to withstand a major surgery. Does she have COPD/emphysema? Does she have kidney failure? Does she have coronary artery disease? Does she have diabetes? And how severe are these conditions, if she does have them? The pre-operative assessment done by anesthesia would assess her risk of complications during surgery, and she would likely have testing done on her heart and be seen by a cardiologist prior to the procedure.

The first step, though, would be to talk to a physician about this. If primary care doctor thinks it is a good idea, talk to a cardiac surgeon. Medicine has changed a lot in the past 40 years. What was recommended back then might not be so recommended now.

Re: JackFlash's recommendation, percutaneous valve replacement is a very new procedure. If surgery is planned (after making the assessments above), it would be something to ask about. Keeping in mind that it sounds like her mitral valve is the problem, rather than the aortic valve.
posted by treehorn+bunny at 9:58 PM on May 13, 2014 [2 favorites]

My grandfather went for heart surgery at about age 83, to repair an issue he had also apparently been born with. For my grandfather, the defect didn't prevent him from living an active life throughout his childhood and most of his adulthood, but apparently made him weak and frail as he got older. Although the surgery greatly improved his physical capacity, it felt like it really accelerated his decline into dementia. Of course I can't know how he would have progressed if he didn't have the surgery, but I will note that cognitive problems associated with heart surgery, and especially with the use of the heart bypass pump, are a widely reported thing sometimes known as "pump head".
posted by Cheese Monster at 2:23 PM on May 14, 2014