Should my 80-year-old father have surgery for his aneurysm?

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My father has been diagnosed recently with an ascending aortic aneurysm measuring 5.5 cm. He was told by two heart doctors that they recommend surgery. My father is very fearful. He has never had surgery before and is worried about the outcome of surgery at his age. Right now he is slow, but feels pretty good. He still plays 18 holes of golf 3 times a week! He lives alone and is of the belief that a quick death from the aneurysm rupturing would be better than suffering if there are complications after major surgery. His only health issue is high blood pressure and tachycardia at times. He is medicated for both. He doesn't smoke or drink and is only a bit overweight. If he was younger or if my mom was still living I could see him going through with the surgery, but at 80 years old is it worth it?

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14 Replies

  • Posted

    My doctor said that surgery is based on size of the aneurysm and age. I am 6’1, 240 and am 43 yr old, My Ascending Aortic Anueurysm was 5.1.  I was told that based on my size, I will likely need to get it repaired at some point, mainly because it will continue to grow. He also said that if I were in my 70’s, he would recommend that I have it monitored, mainly because the time for growth is limited, and physical activity is less. I will say this, I am in my 9th week of recovery, and feel pretty good, but if I were in my 80’s, I would rethink surgery. 

    Frank

  • Posted

    Hi, I cannot tell you what to do, but I will tell you of my two experiences with aortic aneurysm surgery.  My 92 year old father in 2006 and my husband one month ago.  My Dad had atrial fibrillation, but was otherwise in good health for 92 except for having macular degeneration and being hard of hearing. He had an abdominal aneurysm and I'm sorry, but I don't remember the size, but it was large enough that his heart doctor thought it should be fixed.   He was having some abdominal pain.  I don't think his primary care doctor thought he needed the surgery, but Daddy decided to have it.  The vascular surgeon evidently agreed with the heart doctor.  They did the stent graft procedure.  He came through the surgery great.  Spent a day in ICU and was then transferred to the regular floor.  I honestly think he did not get the care he needed after he left ICU.  My sisters and I took turns staying with him. At some point he became confused and disoriented.  We asked for help, but were told this was normal for elderly patients.  He would try to pull IV tubes out and was hard to manage.  The nurses acted like they were aggravated with him.  I called one of the doctors office and he came over, and told them to give him something to calm him down.  Then he started seeing things and talking "out if his head."  They put him bac in ICU and he died from pneumonia.  In thinking about it later, we don't think he was given any breathing treatments after the surgery.  We never saw it done and really didn't know what kind of care he should have been getting.  I think he would have survived had he gotten proper care after the surgery.  Just something for you to think about and be aware of.

    My 72 year old husband had the same surgery a month ago.  He had smoked for 50 years.  Had no idea he even had an aneurysm.  Had a dizzy spell while out working.  At my insistence want to the doctor.  They said he was dehydrated.  I said no, something else is wrong.  I asked for a CT scan and sonogram.  I really thought he probably had lung cancer just because of the years of smoking,  Turned out thatcher had a 10cm. abdominal aneurysm!  Sent him to the surgeon the next day.  Same hospital where my Dad died.  I had said I would never have anything else done there, but this was pretty urgent.  So we went.  The surgeon checked it all out and calmed down by telling me this can be fixed.  I told him my story and why I was reluctant to have the procedure in that particular hospital.  He said he understood and that if we wanted to go some other place he would set it up for us right then and named several places where he knew the doctors.  He said, out team can fix this, but I want you to be comfortable. Then he told us to discuss it and he left us alone to talk.  My husband said, "I like this guy.  Let's let him do it."  So I said ok, but I made it clear that I was to be allowed to stay with him after the surgery in ICU and the room.  The surgeon said he would ok it.  My husband came through the surgery great.  It took about 3 hours, I think.  He spent one night in ICU and came home.  The staff went out of their way taking care of him.  The nursing supervisor for the hospital even came to talk to me before the surgery when he was in for scans and pre op.  He is on the road to recovery now.  He lost 15 pounds because he had no appetite for over two weeks after the surgery.  He is back eating, but us still having to take it easy.  Gets tired really easy.  Can't lift more than 15 pounds and probably won't be back to playing golf for another month or two.  It's really hot where we live.  Best part is he quit smoking so he's fighting that as well as trying to regain his strength.  Everything I read says it takes several months to get back where you were.  I know this is long, but thought it might help.

  • Posted

    Like the 2 replies before me. I can't advise whether your father should have this surgery not. We all can only speak from our experiences and everyone is different. I am a 56 yr old female, no health (no high blood pressure, diabetes or high cholesterol) issues other than a Thoracic (not abdominal) Aortic Aneurysm. It was found 8 yrs ago at 4.8 cm and monitored until this year when it reached almost 6 cm in less than 12 months. I was terrified to have the surgery but the fear of it rupturing was more than I could take. I had the surgery, I'm in my 7th week of recovery. I can not sugar coat it, this has been a journey but remember mine was open heart. I think all of the surgeries are hard on the body and anyone needs a good advocate and support system. My team of doctors and nurses were fantastic. My daughter was awesome as well in advocating for me when I couldn't for myself. She was the best a mother could as for. If he decides to do it just know that recovery is slow and can be painful. Just stay on top of his meds, know the side effects and keep clear and direct communication with his doctors! My mom is 88yrs old, not sure what I would recommend if it was her and she's in good health, but also consider the alternative...

    • Posted

      I am interested in your story. I am your age, no health issues yet have TAA measuring 4.3cm discovered 2 years ago. 2 CT scans and 2 echo's since, show no change in size and being monitored annualy. I am taking beta blockers (2.5mg of bisaprolol). Where you taking beta blockers during the years of monitoring and did you get any symptoms in the last year when yours grew to 6cm?   

    • Posted

      My aneurysm was discovered 8 yrs ago during a routine CT scan for something else. It was 4.6 cm. My doctors said the protocol was to take a wait and see approach. They explained that 5 cm was when they start to consider surgery based off the patient's weight, height and age. They also said that some never grow and are asymptomatic. I had a CT scan every 6 months for almost 8yrs until I had several changes in my primary care physician (VA). I missed 2 scans, that's 12 months and when I got one (about 15 months), it had grown to 5.8 cm.. My doctors were surprised and said it had to be removed because when the behavior changes and it grows rapidly, it could be headed for rupture. I was never given any meds in 8 yrs and no symptoms until it had grown. Symptoms were shoulder, upper back and chest ache. Not like a heart attack but a nagging pain like you injured that area. The doctors told me that was symptoms that it was starting to press on internal organs. Where is yours? They are ascending, descending and in the arch, the location makes a difference. Do all the research you can.. I welcome any questions, I am thankful to be recovery and I want to help anyone I can, especially women because our journey (breasts) is different. I am open to helping if I can..

    • Posted

      Mine is ascending. It all started with my younger sister discovering hers at 5.1cm during a routine check with her GP. She is petite and so she had same surgery as yours within 2 months of discovery. She has recovered well although she is now having problems with keloid scaring. A skin specialist gave her steroid injections which thinned her  skin so much that the clips holding her ribs together became visable. She now needs  another surgery to correct sad.  Interesting to hear that you were having such regular CT scans. I was told that they are too toxic and that echo's are sufficient even though not as accurate. I am under the care of the same cardiologist who operated on my sister and he recommeded the beta blockers. My sister also started taking same dose post surgery.  I have no noticeable symptons yet and neither did my sister although now she remembers occassionaly having swollowing difficulties. Thank you for offering to share your experiences. I agree women have added complications.        

    • Posted

      I a 43 year old female.I had ascending aortic aneurysm.My surgery was on 5/23/16-7 weeks ago.My story is long.Just keep being vigilant.This has happened so fast to me.I'm surprised how common it is and how little information there is out there for the general public.my hope is to somehow raisee awareness for this silent killer.all the best-kim

      Check out the JohnRitterFoundation

    • Posted

      I agree, there should be more awareness. No one in my family had ever heard of the condition until my sister was diagnosed and fast tracked into surgery. All siblings were tested and one more sister age 46 has it mild at 4.1cm. Aneurysm is in the same place for all three of us (in the arch). Why us and not our brothers. Who knows... 
  • Posted

    Believe me when I tell you it is not quick when it dissects. I watched my Husband in agony on our kichem floor waiting for the ambulance. He was 78 and quite fit before this. He was rushed first to the local hospital then to the Royal Brompton where he went into theatre and was there for 17 hours. This was his first time for surgery. He will be 80 this year and is fine. Tell him to go ahead.Good luck. Xxx
    • Posted

      just read your message and was wondering why he was under anesthetic for 17 hours which is a hell of a long time, when you say (dissects) do you mean the artery burst?, I'm 78 and have to have a ultra sound scan as they found out by chance in an Xray I had for a painful hip that the tear in my abdominal aorta was 7centimeters long, I am, after reading of elderly people having really bad after effects of the anesthetic really scared, but there are no alternatives. JRD.

    • Posted

      Oh wow, your husband is an anaomaly and very blessed. Once dissection occurs it's usually lights out within 2 minutes and even if you get to a trauma facility and in surgery fixing a dissecting aneurysm is hard.

  • Posted

    I wish all of you who have this condition the best of luck and my prayers. My husband just had an open aaa surgery in April. His aneurysm was 6.1 at the time. Wow, it has been tough. He had an operation which was supposed to be 4-5 hrs. Lasted 8.5. Was only out of surgery a few hours and had to go back into surgery for a renal artery bypass. Came out of that one and had a stroke due to their inablility to control his spiking and dipping bp. (This was a second stroke for him.) After all this he now has no kidney function and has to have dialysis 3 times a week. We were told of the usual risks but nothing prepared us for this. He also had a bowel obstruction which corrected itself prior to leaving the hospital thank goodness.  Spent a month in ICU and 2 months with home health care for the stroke residuals and to try and regain his strength. He lost 30lbs and its almost 3 months later and he is doing better but still quite weak. My husband is only 66 and was in pretty good health when he went in. Oh and don't forget while in ICU we went through days and days of extremely bad delusional episodes, Please give any major surgery extensive research and thought. As we told our surgeon, had we been made aware that he may be on dialysis the rest of his life we would have opted out and took our chances for the rupture. He apologized and said in hindsight he should have gone more in depth with the risk. You think!!!  Don't let me scare you, it's a personal choice. Just please ask, ask, and ask questions and know the risks, in depth. Good Luck to all of you.

    • Posted

      WOW!!!!!!

      I am very sorry to hear of your husband's fight for life! You are right, you REALLY have to ASK QUESTIONS!!! Doctors by design don't tell you of all the risk, I wish they would. I was told, it's because the patient gets more stressed out with more information and it makes it harder to get the patient to commit to the surgery. I think you should be well informed about all the risk. I inquired many times and researched a lot and then went back to verify or not, the info I found on my own. It was SCARY committing to having such a major invasive surgery done. Mine was THORACIC not Abdominal. Don't ever give up and don't give in. Continue to research the issues that he has because you may find something to help him. I know this has been traumatic for both of you. Continue to pray and educate yourself and others. This is the place to come to inquire, share or vent! I am praying continued strength for you both and that your husband's health continues to improve.

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