82 yom, pradaxa(afib) til 7/8, when pain, small gangrene 5th toe. now much worse.cabg, dementia, uses walker. arteriogram/surg possible before 7/15?

Toe go or not toe go: If the question is will you get an arteriogram/surgery for the gangrene toe by 7/15, well anything is possible with persistence. If you already have an arteriogram +/- surgery scheduled and you are asking will the gangrene toe delay the procedure/surgery,, as an ER doctor, I refer cases to more types of surgeons that anyone and this will likely be surgeon dependent based on physical exam.

Dep on renal fn: Understanding the question to be about the time between the d/c of Pradaxa and timing of surgery with respect to risk of bleeding. If renal function is normal then d/c Pradaxa 48 hours prior to surgery is safe re- bleeding risk. If Ccl

If needed save life: if the procedure can prevent death or amputation at higher levels ok. the risk of thrombosis and death to stop pradaxa and other meds may take precedence

Arterial noninvasive: The 5th toe gangrene could be caused by an embolus or from severe peripheral vascular disease. To make that determination easily the patient needs an arterial noninvasive study. If pt has PVD, then arteriogram and revascularization is appropriate and sooner rather than later.

Unclear question.: certainly consulting current treating physicians about surgery on the toe makes sense. The things that increase risk of heart disease and need for CABG all increase likelihood of dementia. Major surgeries like a CABG can cause, worsen and/or make cognitive impairment and dementia more apparent. Palliative care and symptom management may be a preferred approach.