How to treat pleural effusion in my grandmother?

Question

Hi doctor,

My grandmother had open heart surgery three years ago and replaced a valve. Now, she has pleural effusions, cannot breathe or talk well, and is hospitalized. Some doctors recommend another valve surgery because it is damaged and misplaced, and some say it is dangerous in her condition whether she goes for the surgery or not. She is about 79 or 80 years old. What do you suggest?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. Redo surgery is usually risky for most people, especially in older age. Specifically, it depends upon many patient and procedure-related factors. Which valve was implanted, aortic or mitral? Which type of valve was implanted, tissue valve or mechanical? Usually, in old age, tissue valves are placed that last for 5 to 10 years, sometimes more also.

In case of aortic tissue valve failure, one option is TAVI (transcutaneous aortic valve implantation), which can be implanted in some carefully selected patients. This is much less risky than redo surgery, but only some patients are candidates for it, as many do not suit the criteria for TAVI. There is also a new transcutaneous mitral valve replacement (TMVR) option for the mitral valve, but it also requires expertise and only some patients are eligible for it.

I hope this helps.

Please revert so I can assist you further.

Thank you.