Aortic and mitro valve replacement - 90 year old female

[Rolodr]

Looking for an opinion on performing both mitro and arotic valve (valve-in-valve possible?) replacement on a heathly 90 year old white female. She had mitro valve replacement approx. 10 years ago and recovered extremely well. No other health issues- very active, not diabetic and mentally sharp (taking care of bed-ridden husband and 97 year old sister in her home-does all shopping, paying bills, setting up home care, etc. Suffering from adema and shortness of breath. Aortic valve closed 85%, mitro 30%. Main aprehension of first doctor's opinion is chance of stroke during surgery. This patient should not be "written off" due only to her age.

[plantwoman]

Also agree regarding age but very surprised that a lady of this age would be offered this op. and don't believe it would be offered in the UK where I am. I get good treatment in a Heart Centre and it's all FOC of course but being over 60 the possibility of a new heart is out of the question. It's just not possible here. I have a
a prosthetic MV and my Tricuspid valve is leaking badly and I am in AF all the time despite my pacemaker. They have said no to surgery once but I have asked again and my cardiologist said "they don't like going in twice".  I am astonished by how active your 90yr old is.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
In the elderly, common causes of aortic valve stenosis are calcification (very common, almost all have this) of a congenital bicuspid aortic valve and degenerative aortic stenosis. Rheumatic heart disease is the cause in about 20% cases. If the elderly lady is very symptomatic then only surgery should be tried because prognosis in stenosed aortic valve is poor without surgery. Hence if she is fit for surgery then maybe this should be tried. Otherwise she should be medically managed if she is not symptomatic and followed up regularly.
Hope this helps. Do let me know if there is any thing else and keep me posted. Take care!

[gmachris518]

I couldn't agree with you more, that age should not be a determining factor for any kind of healthcare.  It seems with the "new" presidential structure that is the direction the medical field is headed, and it looks like in the near future that if you're over 59 years of age then you will be told to get used to the idea of dying, and not hang around to be a burden on society or your family, and it scares me to death, since I am 56 with CHF and End stage renal failure.....I would at least like to have the chance to try to live longer, and I don't think it's fair for the Gov. to tell people when they should die, or whether they are "worth" trying to save or not.