Follow
Share

Do nothing or TAVI for aortic stenosis. My soon to be 90 mama was recently diagnosed with severe aortic stenosis. She also has some dementia, hearing loss and generally has difficulty processing information. She does volunteer twice a week which is wonderful for her and her Dr. says for her to continue with her volunteer work as long as she wishes. She lives with my husband and I. I have both financial and health Durable Power of Attorney. Her stenosis symptoms were very low blood press/pulse, swollen ankles and fatigue. She is 89 lbs. Lowering her high blood medication greatly improved symptoms. She was referred to a cardiologist and had an echocardiogram. Her regular physician provided us with the results and options, but a full report, etc. will happen when we have a meeting with the cardiologist in two weeks. The two options the cardiologist will further discuss are 1) a fairly new procedure Transutaneous Aortic Valve Insertion (TAVI) where they go through an artery in the groin (there are risks) or 2) do nothing (risk is heart attack/stroke, this is a known risk at 90 already). Because of her mild dementia and difficulty processing information she doesn't seem to recall the conversation with the Dr. and thinks all is fine now that her blood pressure is good. My heart tells me let her continue to think that - ignorance can be bliss.
She has always expressed that quality of life is most important to her and her Health Care Directive reflects those wishes. With that in mind I can't see taking her to a consultation with the cardiologist or having the TAVI procedure. I think the surgery could be successful from a cardiology standpoint, but it will take such a big toll on her physically and emotionally (depression). Discussions on the risks, preparation, fear of staying in a skilled nursing facility for a few days or worse fear of not coming home will just be so hard for her. On me too. There is more to loose than to gain. What I want is confirmation that not sharing all this with her is not only okay, but in fact is the most loving thing to do.

This question has been closed for answers. Ask a New Question.
Your answer is in your posting-"She has always expressed that quality of life is most important to her and her Health Care Directive reflects those wishes." I had too make the difficult end of life care decision on behalf of my mother. Even though she is gone and I miss her, she lived the life she wanted until the very end.
Helpful Answer (2)
Report

Nope, I would not do this. Ask about the anethesia used. We made a decision with regards to mom (91, post stroke, post dementia, post broken hip) that we would not do any procedure that require general anethesia...we were quite fortunate that they were able to do the hip under some sort of local. My MIL, who was 80, had an aortic aneurysm that required the sort of surgery that requires cooling the patient down quite a bit--my husband had had it a few years prior. My poor MIL never recovered. She refused rehab, probably due to ministrokes that occured during or right after the surgery and then basically starved herself to death. Point is, I would not subject your mom's body, mind or soul to a procedure like this. If she's not in any pain and is a happy camper, I would leave this in the hands of fate.
Helpful Answer (2)
Report

Thank you to each of you for your responses. They do help.
Helpful Answer (0)
Report

Medicare will not approve a TAVI for patients with co-morbidities such as frailty, dementia, kidney, liver or lung impairments. I think you are making the right decision to avoid the procedure, it has a long recovery period, significant risks and emotional turmoil. If it was my mother, I would say no.
Helpful Answer (3)
Report

Only you can make the decision for your mother. There is no "right" or "wrong" answer. But if I were in your shoes I would go no further. I think there is more to lose than to gain.

I would not criticize others who would decide differently. But I'd decide as you are planning to.
Helpful Answer (2)
Report

It's ok. Anesthesia will also most likely diminish her mental capacities.
Helpful Answer (2)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter