86 year old man with large inguinal hernia slipped into scrotum. Family is concerned for heart to withstand laparoscopic surgery. His internist/staff have proven incompetent in several areas and I don't trust their evaluations. Looking for a reliable cardiologist but none in our rural area. Has afib, chf currently. Current daily meds: warfarin 5 mg, furosemide 40 MG tablet, carvedilol 3.125 MG tablet (2x), DIGITEK 125 MCG tablet, lisinopril 5 MG tablet. Has lived with hernia for 2 months.
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Evaluating heart strength to withstand surgery
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The benefit of the surgery is justifying the risk. To control the risk, inpatient preparation would typically involve achieving a dry weight state for CHF as well as medications adjustment (warfarin).
It is difficult to do a thorough pre-operative risk assessment on paper over the Internet without seeing the patient and laying hands on him. But in general, as long as there are no symptoms of angina or chest pains and there is no uncontrolled symptoms of congestive heart failure, then most likely, the operative risks should not be increased for surgery. That's in general. It would be best to get an pre-operative risk assessment by a Board-Certified Cardiologist electively before the surgery to make sure