My husband is 78 and has Aortic Valve Stenosis. He also has dementia. I am afraid it will compound his dementia.

Jan, once dementia walks in the door, there are no "good" or "right" choices. There are only the less bad ones.

Once I saw that hospitalizations set my mother back rather than improved her poor health, I realized that palliative care was the way to go.

No interventions. No 911. Whatever was wrong, they were going to have to fix it in the NH, not in a hospital.

Aortic valve stenosis is not an emergency.

My husband had a 5.8 mm aneurysm and a leaky aortic valve. (He was 50, no dementia).THAT was a life and death situation and he had full open heart valve and aortic replacement surgery.

Stenosis is not an emergency. I would leave it be.

Full valve surgery is with open heart and at least 4 hours of anesthesia. If it is a TAVR, then it is minimally invasive. You can ask for a second opinion and you need to consider quality vs quantity of life. If you choose no surgery, you can also ask about a hospice consult. The only thing I cannot predict is longevity with a leaky valve.

I would do absolutely nothing to extend my mother's life after her dementia advanced and Sundowning was causing her extreme anxiety every day. Where's the quality of life with dementia??? Knowing it will continue to advance after this life-extending surgery, causing your husband even more misery, with diabetes and other health issues? I personally think it's not "selfish" to refuse this surgery, but an act of kindness. It's cruel to extend a dementia patients' life one day longer than nature intends it to be.

Best of luck to you.

Heres an article on TAVR that SP mentioned in her reply to me

https://newheartvalve.com/understanding-tavr/what-is-tavr?utm_medium=cpc&utm_source=google&utm_content=TAVR%20Core&utm_campaign=Management%20-%20TAVR%20-%20EX%20-%20SVD&utm_term=tavr

A Balloon Valvuloplasty is usually done with light sedation but he would probably need to be put under because of his dementia and he will probably have to remain sedated after the surgery because you are required to lie flat for a certain number of hours. He will probably need to be in the hospital for at least 1 - 2 days.

Why would this not help with his quality of life. Right now the heart is not pumping efficiently. My Father and MIL had valve replacement surgery in their mid 60s. Both saw a difference. I think now the operation itself is very simple from when Dad had it.

Anytime you go under after a certain age, it effects memory. My Dad was told the longer he was under, the more memory would be lost. It can make Dementia worse. You need to talk to the doctor about your concerns with Dementia involved. You are his Caregiver, not a trained professional when it comes to after care. I read there are treatments if not severe. The blood has to be able to move properly thru the heart. It can't when a valve is not working properly. Another factor would be what stage is his Dementia in? If the last 2 stages, I may not opt for the surgery.

What kind of surgery? Are we speaking of ablation for the atrial fib or are we speaking of valve surgery? If value surgery, this is something I would never do at this point. Only you can decide, if you are now MPOA for a husband with dementia, about the quantity versus the quality of his life ongoing. Hospitalizations are very difficult. And anesthesia for something like valve surgery is major, to say nothing of blood thinners and their side effects afterward, and this for a heart with electromechanical problems (atrial fib) as well as mitral valve problems.

As a former nurse in cardiology this is not something I would choose for myself, nor for my husband at this age, no matter dementia or no. The decision must be yours, and can only be yours.

Are they wanting to put in a pacemaker? There is a recent thread that deals with this issue:

https://www.agingcare.com/questions/should-my-mother-get-a-pacemaker-483444.htm?orderby=recent�

Did your husband ever create a Advance Healthcare Directive? (aka Five Wishes, aka Living Will)

Lots of good pro's and con's for you to consider on that other thread. I wish you wisdom and peace in your heart whatever your final decision is.