Unsuitable for Aortic valve replacement

[PandyNW]

Hi, usually just soak up all the positivity and advice in here but now have a question relating to my 84 yr old dad. He is in hospital, having been rejected for a 2nd time for valve replacement (all within the last 12 wks). They have said the risks are too great for him. But surely the risks are also too great to leave it untreated? He's not being medically treated at the mo, but the hospital require an assessment of his home set up before they will allow him home. Yesterday he was fully 'with it', making lists and plans for coming home, and assessed by physio as capable (stairs etc). Today he is breathless again and despondent, and assessed as not capable. I don't know what I'm asking really, just hoping for a light at the end of the tunnel 😕

[MONIREN]

It wouldn't be easy to see your father vulnerable and struggling. I am sure they are trying their best to make sure of every option. I don't know what is involved in that condition. Just wanted to let you know that we all care for you and your family. Take one day at a time. Moni

[10gingercats]

I guess the refusal is due to him being under anaesthetic for too long at his age. I had something similar, a refusal, for a tricuspid clips op.I am 83. They may well do it if you/your father insists and acknowledge the risks .If his general health is good with no comorbidities you may be able to twist their arm but be aware of the risks.Worth asking about the medication treatment if they do not want to operate.

[PandyNW in reply to 10gingercats]

Thank you both for replying. He also has COPD, so that won't help his cause. I've been reading through here about heart failure meds, so I will try to speak to his hospital doctor about this, as nothing has been suggested. Just trying to phone the ward is nigh on impossible!

[MoyB in reply to PandyNW]

Hi! The COPD could be a stumbling block. I was due to have a simple bunion op but the hospital I had been referred to couldn't do it. The reason they gave was that they were only equipped for straightforward ops and would be unable to give me emergency care if a problem developed due to my COPD.

I was referred to another mainstream hospital and had the op with no problem.

Some anaesthetists are very unhappy about treating COPD and if that is the case, it may be possible to find another one who is more confident.

I would suggest you ask exactly what the risks are and whether they could be reduced in any way.

Have they considered the TAVI procedure for him? My 79 Yr old husband had it done in November and I understand that it was done under sedation rather than anaesthetic.

Above all, please ask your Dad what he wants to happen and support him with his decision.

All the best, Xx Moy

[Blackcatsooty]

What a difficult position for you. It is a big operation, so maybe the medics are alarmed about the consequences.

The necessary anaesthetic is significant. You need to do post op exercises.

Some possibilities are:

1) TAVi. Have the doctors discussed this option.

2) Any chance of going private ?

Maybe just a consultation, costing a few hundred pounds. But the whole op cost me a little over £40,000.

I went for private, aged72 and it saved my life. Hospitals were closed due to covid. So private or wait. I would not have survived the wait.

A private consultation would clarify your options.

Cat adoring Colin

[MichaelJH Heart Star]

Hello and welcome to the forum!

I assume that we are talking OHS (Open Heart Surgery). Sometimes in older or those with comorbidies a less invasive TAVR (Transcatheter Aortic Valve Replacement) can be used. This in fact is what Mick Jagger had carried out at the start of the pandemic. It may not be suitable but it is worth raising as it does not seem to be offered that frequently.

[PandyNW in reply to MichaelJH]

I believe the TAVR procedure is what he has been turned down for. I don't think OHS was ever an option for him.

[10gingercats]

I was told that even with a TAVI it may happen that should anything go wrong, such a big bleed, while surgery is being carried out they will then resort to open heart surgery while you are still under.I am not not trying to scare you. This is what I was told by the lead surgeon who may have operated on me.

[Blackcatsooty in reply to 10gingercats]

Exactly what my surgeons told me..

[PandyNW]

Thank you for taking the time to respond. I definitely need to try to speak to his doctor and understand why they have rejected any procedure, and where do we go from here. Feeling like they have basically closed the door on him, it's very upsetting. Thanks again.

[Qualipop]

You must absolutely insist on speaking to his doctor and getting full information so you can help your dad make the right decision

[colourblue]

So sorry that you & your Dad are going through such a worrying time. I can't add any more to what other people have said, but would like to send my best wishes to you both.