Aortic stenosis in the elderly - advice please!

Hi Rowantree. I have had AS from birth and mine is mild to moderate. I am, however, still being told that I will be having surgery in the future. They insert a pig valve (up to now, although new artificial valves are being developed all the time) to open up the Aorta and let the blood flow more freely. If your MIL is being told that she needs surgery now, then she does. Apparently the recovery time is not as long as it used to be but then she is an elderly lady so that could be a bit longer.

Can her children/DGC or any other family members or friends help to update the property she is buying? Or can she afford to get people in to help and she just points and pays? My dad moved recently and I got a decorator in and a new carpet laid. He loves it now. He has dementia.

I moved last year, with my son, no help other than him and the removal men. It was very tiring but if she is well prepared and there are other people around to pack up for her, move things around, do anything she wishes and she can just point and instruct (and drink tea), then it would make moving easier.

If none of these are an option, then it is better to stay put and have the operation. She may, however, recover better in a home she loves and feels is a new start for her. If she does not want the operation, then no one can make her but it is like a hope pipe being squeezed, the more severe the condition, the less blood is getting round the body.

In your father's case, if he has been diagnosed now with AS, then the consultant will probably just keep a very close eye on him with tests and medication and checking his symptoms. He will have scans, ECG's and monitors to make sure it is kept in check. Is he on medication for it now?

I am to have an Event Monitor on next week for a week or so to check on mine. They do this from time to time, but I have other heart conditions too, for which I have already had two open heart surgeries.

I wish you luck with both your father and your MIL, these things are not easy to live with. I've had it now, visiting cardiologists for over 50 years.

to all of you.

Oh my goodness- what a dilemma. Does she want to move really? If she's had enough of her house and wants a new start then encourage her to fulfil her dreams (this may be a cherished dream to have her own chosen place) and this, in itself, could make for a good recovery. My gut instinct says go with it. This will, in itself, have a good effect on your father too - that you are listening and not writing them off - i.e. they have a future. Rubylady is talking good sense and is coming from personal experience, I'm not.

I was born with AS, I had an artificial valve inserted 8 years ago, I was in hospital for 2 weeks and it has been a great success. I was just 52 when I had the op, and was at that time very fit.
My real Mother(her choice of title so the PC brigade can put a sock in it) also has it she is 81 has been offered the op but is still undecided.
It is a huge operation but has a high success rate.

Thank you felice you have put my mind at rest for when I have to have the operation. Not looking forward to it, obviously but it will have to be done at some point. How bad was yours? We have both lived with ours for over 50 years, although like I said, mine is mild/moderate.

Hi Ruby, mine was also quite mild, I had 3 children, and my job involved doing a lot of sport, then i changed career and became a Chef, also hard work.
It changed very quickly, I remember walking up 3 flights of stairs after putting out the rubbish lying on my bed thinking,'my heart hurts'.
DD hauled me to the Doctor, straight to a Cardiologist, had an Angiogram the following day and operated on 6 days later. The valve was so closed that the Cardiologist could not get the line in to check it during the Angiogram.
The period in ICU was not too pleasant, but just 48 hours, then up and about and home. I had set myself a a target of going to a St Andrews day function here which was 3 weeks after the op. Went and enjoyed it.
Good luck, it is a scary thought but really makes a difference.

My MIL has decided not to go ahead with the house purchase right now. She wants to focus on getting well and is stressed and anxious about the possibility of an op. We would support her whatever her decision, I hasten to add, but we're trying to find her a good hospital. Unfortunately the NHS can't give her an appointment for an angiogram till the end of August and my OH and his sister felt that was too long, so she's using her insurance to go private. I shudder to think what it would cost otherwise. I've always put my trust in the NHS and we don't have insurance ourselves, but it's her final decision in the end.

My father has been told that no action is required - his is moderate and apparently doesn't require any more than 6 monthly check ups. Not sure I believe that but he's very independent and in any case my stepmother is on the case and would tell us when anything was worrying.

Rubylady I hope all continues well for you. Thank you, and everyone else too, for your comments

My DH had an aortic valve replacement 5 years ago and graft for a large aortic aneurism close to the heart which was affecting the aortic valve. What rubylady picturesquely calls a " pig valve" aka in medical terms a " tissue" valve was used out of after care preference, a metal valve would have required lifeleong anticoagulants (although AF means he is on Warfarin after all).
I believe, although don't quote me on this, that a metal valve is used for younger patients whose life expectancy may be longer than that of a tissue valve. As DH was 62 when he had his, seemed fair enough.
TBH of all the parts of his body which the NHS takes care of, his heart is probably the best functioning!

My friends GD has had valve replacement with a metal valve as she was only 4. Poor little girl had a virus which affected her heart and she also had a stroke. It was touch and go for a while but she managed to start school along with her peer group. She still has impairment down her left side but the valve is working well.

It doesn't have to be open heart surgery. In 2008 when my father was 92 he was considered for a then pioneering operation to replace his valve using key hole surgery. The operation was developed with people like my father and Rowantrees mother in mind.

My father did not have the op because he was in hospital being treated for an infection that kept re-occurring and they couldn't operate until the infection cleared and in the end the infection never cleared and he died.

Not every hospital offers this op but here is a link to one that does. southtees.nhs.uk/services/cardiothoracic-services/aortic-valve-replacement/ and gives you plenty of information. If you live in an area that doesn't offer the op you should ask your GP to refer your mother to a hospital which does do it. There seem to be a lot who do.

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How bad does aortic stenosis have to be before the NHS will operate?