Aotic Stenosis and 2 LAD block

[fjeeva]

My father is 60 years old and he has developed severe aortic stenosis. His angiography was done today and it was found that 2 of his arteries LAD are blocked (90%). He has type 2 diabetes and is hyper tensive. He is asked to have a bypass and valve replacement. What are the risk factors involved and is there anything to worry about??

Can someone please give views?

[ed34]

One big issue as stated is infection, especially in the Lungs. A small infection tends to become quite severe when the body is weakened from surgery and can actually develop into chronic pneumonia. Ensure lung function tests and an xray are performed before surgery. This is usually a standard procedure prior to surgery in the UK. Good advice has been offered by Yvette regarding nutrition because you can't usually eat anything for a couple of days after surgery, the medication just seems to kill appetite.
With regards to general surgery risk, the operating theatre is built for all types of emergency, including a bypass machine and other life support. Have a chat to the surgeon who will be performing the procedure, they are usually honest at how confident they feel about the outcome.

[Yvette BG]

Is your Dad having symptoms? From what I understand, symptomatic patients with severe aortic stenosis if left untreated have a high risk of death within 1-3 years (50-65%); those statistics don't take into account the presence of severe LAD blockage as well.  

Overall, open heart surgery carries the risk of death, stroke, and infection. With a person with diabetes, they also have to monitor kidney function very closely, especially if they've already had some renal insufficiency.  

Surgical risks vary from person to person, depending on overall health and strength, etc. For my Dad, who was 83 when he faced surgery (his aortic valve replaced for severe stenosis, triple bypass for blockage, and repair of a transthoracic aneurysm; he also has diabetes and long-standing hypertension and had developed heart failure
and anemia), they said he had about a 90% chance of survival. He had his surgery last year (no stroke or infection) and is still alive today.

If surgery is in the plans for your father, it would be best if he could get built up nutritionally now if he is at all depleted, hasn't been eating well lately or tends to be anemic. This may help with the healing of his incision, etc.  And he should try to get his blood sugar as well controlled as possible before the surgery.