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Hello. Welcome to JA. There is no question that gaining weight, or moreover, strengthening his upper body/chest wall would help him be a better surgical candidate. Has he had any of the presurgical evaluation looking at his pulmonary function (perfusion CT scan, or V/Q scan)? Looking at his blood work, what is his albumin level and total protein level? What is his renal clearance (CCL)? These figures would determine his eligibility for surgery. I cannot tell you without looking at his cardiac studies what his potential for improvement is with surgery, if you have any of those studies, you can upload them leaving off his name, as this is a public forum. I will then give you a response based on his numbers. Dementia by itself is not an exclusion for surgery, if that is your question. It could be the dementia is a vascular dementia, related to the same condition that is reducing his heart function. If that is the case, and this is not Alzheimer's Dementia, then increasing his coronary perfusion and cardiac output may help his overall mental status, much as you see when using oxygen. Please get back to me with questions and/or more information, and we can discuss this until you are satisfied. Or if satisfied with this answer, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work thanks *****
These are decisions coming from within, you have known him and his situation better than anyone else. If you need suggestions, please get back to me and I will reply. Dr frank