[HSF] Indication for elderly patients

[Nasser F. Abou'Seada]

"Remember - it is not the years, it is the mileage."
Mich:
for a change .... your dictum totally reflects our "shared" philosophy

NFA



On 7/27/07, Michael Firstenberg <msfirst at gmail.com> wrote:
>
> Remember - it is not the years, it is the mileage.
>
> -michael
>
>
> On 7/26/07, Ben Bidstrup <benjamin.bidstrup at bigpond.com> wrote:
> >
> > Tohru,
> > One of the most satisfying things for me is to see an older patient
> > such as yours coming back after a few months and even annually as i
> > follow my own patients, able to lead for them a normal life. That is,
> > without SOBOE and angina, able to garden for a few hours or play
> > bowls or even just walk to the shops.
> > I look less at their expected life span and more at what could be
> > achieved by replacing the valve over the next 6 months. Give them a
> > few years at NYHA1. Sure there are risks, and the literature is full
> > of references to the higher mortality and morbidity of these older
> > patients. Most are quite pragmatic and would rather face death than a
> > life being sedentary.
> >
> > >Dear members
> > >
> > >I was asked to operate 90 yo man with severe AS (AVA0.68). He had been
> > >intelligent and independent otherwise. Yesterday PM, I performed AVR
> with
> > >CEP. He was extubated and is on diet today.
> > >
> > >What actually do you do for indications of cardiac surgery in these
> days.
> > Do
> > >you apply same indications of younger patients, if otherwise seems OK?
> > >
> > >What is the philosophical indication of each member?
> > >--
> > >Tohru Asai
> > >
> >
> >
> > --
> > Ben Bidstrup FRACS FRCSEd FEBCTS
> > Consultant Cardiothoracic Surgeon
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