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الدكتور احمد اشكوكاني
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الأسئلة المجابة 17244 | نسبة الرضا 98%
Doctor
This is in regard with my Father's Health issue....
This is in regard with my Father's Health issue. Recently we have consultated a heart surgeon as my dad ( 73 yrs old) has many ailments like knee and foot joint pain, stomach and gastro issue and all these are related to functioning issues of Heart. recently we have conducted CT scan and as per the report it is stating as " SMALL CALCIFIC ATHEROMATOUS PLAQUES ARE IN THE AORTIC ARCH, THORCO- ABDOMINAL AORTA, LEFT PROXIMALSUBCLAVIAN ARTERY, RIGHT BRACHIOCEPHALLIC ARTERY AS WELL AS ILIAC ARTERIES , HOWEVER NOT ENCROACHING ON THE LUMEN"
AORTIC VALVE- MODERATE TO MARKED CALCIFICATION IS NOTED IN AORTIC VALVE CUSPS AS WELL AS THE ANNULUS.
CALCIFICATION IN AORTIC VALVE IS NOTED WITH SIGNIFICANT CORONARY ARTFERIAL CALCIFICATION.
based on the Heart surgeon has advised to carry out Keyhole surgery to remove blockages as well valve replacement. since my father is high sugar and BP as well so they recommended for Keyhole surgery rather than to go for open heart surgery.
I need an expert advise on the above whether surgery is mandatory considering his age and parameters like high sugar, BP and minor gastric and stomach pain. as per doctor, since the blood is not pumping to other parts at its usual way so my dad is having assosiated ailments like knee joint pain, stomach and gastric issues very often in mild way. could you please look into my case and englighten what should i do to recover my dad's health in a good manner.
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إجابة الخبير: Yazan Alhourani
Yazan Alhourani
Licensed Physician
الأسئلة المجابة 75463 | نسبة الرضا 98.7%
Dear customer , we have checked your question and we will arrange doctor to reply you as soon as possible
إجابة الخبير: الدكتور احمد اشكوكاني
الدكتور احمد اشكوكاني
طبيب
الأسئلة المجابة 17244 | نسبة الرضا 98%
Will the father need the surgery ?
Well, according to the CT results above there is significant aortic valve and coronary artery disease, so in usual situation there is a strong reason for intervention, which could be endovascular or surgical intervention.
Taking all the data together, this surgery, though minimal invasive, still recognized as a major surgery with very high risk of morbidity and mortality, and what decide the surgery is the finding mentioned above and the degree of limitation in daily life as well as patients life expectancy. There are several scores by which the patient can be scored, one of the most important is the ASA score, used mainly by the anesthetist to categories the degree of danger, knowing that the patient is old age and has multi-vessel disease as well the chronic illnesses he has all together would classify him as major risk for complication and death, and all should be balanced with life expectancy of the patient and his life performance, so if these is severe life limitation and life expectancy is accepted the patient should do the surgery even though the surgery has a major risk, but this risk should be lower than leaving the patient with this significant finding of CT, as those finding have its own effects on the body and they are life-limiting by themselves.
If the surgeon and the anesthetists decided to go for surgery, they should try to decrease the risk by correcting any modifiable risk factors, those would include correcting anemia , blood pressure, correcting diabetes, doing cardiac cath to optimize cardiac function for surgery, optimize the patient nutrition, and choosing the best way to intervene with minimal trauma and minimal time, sometimes medication should be given , and blood transfusion would be necessary.
The advice that should be given is that, the patient should be seen by anesthetist, ICU doctors and the surgeon, in order to classify his severity and life limitation from the disease, benefits and risks should be weighted, surgery should be done whenever the benefits outright the risks, they do so by making complete physical exam and detailed history , and the investigation such as CBC, organ functions, Cath, and others, this is not a uni- decision from the surgeon , but it should include the different medical specialties and the patient with his family.
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الدكتور احمد اشكوكاني
طبيب
الأسئلة المجابة 17244 | نسبة الرضا 98%
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