Surgery Second Opinions

I have a second opinion / alternative surgeon process going with the Mayo (less than 2 hours away from my home) that I mostly started due to frustration with poor communication with the heart valve group I've been seeing fro 20 years, and that did my very successful repair in 2002. Of course, as soon as I started the second opinion process my group finally called me, and I am scheduled for mitral valve replacement on 10/16. I didn't tell them I have a second opinion going.

The issue I am wrestling with is the recommendation that I proceed pretty quickly. I was advised by my original group on 8/29 that having surgery "within a month" was a good idea (and then they ghosted for almost a month). When I got an educational consult from Cedar Sinai last week, they also said a 1-2 month time frame because of my TIA. I feel mostly okay as long as I don't have afib . . . I am worried about the afib becoming permanent in the next few weeks and making surgery more difficult, or having another TIA. So that by farting around with a second opinion and maybe having to wait longer to be treated at the Mayo, I'll screw myself over.

I do feel like my local group is capable, it is a comprehensive valve center involved in a lot of research. I'm concerned about some really poor communication and if they have other systems/processes that are not well organized.

Theoretically I can at least meet with the Mayo surgeon before my 10/16 local surgery appt. -- they told me 10 business days max. I didn't do any second opinions for my repair because it was more of an urgent situation, so this whole process is new.

Can anyone share what they did for second opinions and how you decided, felt about it, thought about the process?

dornole said:

I have a second opinion / alternative surgeon process going with the Mayo

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dornole said:

Can anyone share what they did for second opinions and how you decided, felt about it, thought about the process?

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I am about 2.5 hours south of Mayo, and I have relevant experience. In Aug, 2023 I asked Mayo for a 2nd opinion regarding my open heart surgery which was scheduled for late Oct at the University of Iowa. Since I had all the necessary test results in my U of Iowa records, within 2 weeks Mayo gave me their 2nd opinion, which was consistent with the U of Iowa plan. Mayo was VERY helpful during this process. The process started with an experienced cardiology nurse interviewing me for a full hour to ensure she fully understood and documented my case.

Important point: She gave me useful insight into the tradeoffs between a bioprosthetic aortic valve and a mechanical aortic valve. I am grateful to her for that discussion which went beyond generic statistics and platitudes. She helped me consider this decision from my personal background and status.

Mayo also offered me a mid Sep surgery date with Dr Daly. I decided it was best for me to do the surgery in Sep rather than waiting until the end of Oct, so I had my surgery at Mayo. Mayo is an AWESOME place for heart surgery.

Note: I think the University of Iowa Hospital has great medical staff, and I still have my cardiologist and electrophysiologist there. They are a very, very good medical team. However, Mayo got me in 6 weeks sooner.

Wow

3mm said:

Important point: She gave me useful insight into the tradeoffs between a bioprosthetic aortic valve and a mechanical aortic valve. I am grateful to her for that discussion which went beyond generic statistics and platitudes. She helped me consider this decision from my personal background and status.

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from 12 years here that's about the only time I've ever read anyone get that ... fantastic.

I think that it must be systemic down there at the Mayo, because Dr Schaff is from the Mayo.

Heartening stuff

Thank you for sharing your experience 3mm. I did start the process at the Mayo and had a 40 min consult wherein the PA did explain a lot. I’m impressed with their process. However it was looking like December for surgery at Mayo and I really don’t want to wait that long. My afib is getting more frequent and is debilitating - because there is no “atrial kick” to help clear the left atrium of all the buildup caused by the mitral stenosis and regurgitation, symptoms are markedly worse when it is occurring. For example I have to pause walking down my driveway to the mailbox, out of breath like I was sprinting just to walk 60 feet on flat ground. It will complicate the surgery if I’m in afib and I remain at elevated risk for another TIA or stroke without higher-range warfarin vs Eliquis (and it makes no sense to start warfarin now with surgery around the corner). So I’m going with the earlier date and putting my trust in my local team that has been following me for 20 years and does have a comprehensive valve center. It’s nice to have a couple good choices. I’m at peace with it and just focused on mental prep now to bring curiosity, gratitude and levelheaded to this process. It’s a real weight off my shoulders.

dornole said:

So I’m going with the earlier date and putting my trust in my local team that has been following me for 20 years and does have a comprehensive valve center

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In my view, you are making a wise decision.

You already have a second opinion from Cedar Sinai that it is time for surgery. You have severe symptoms and there seems little doubt that it is time for surgery and not delay. While Mayo Clinic is a very respected hospital, given the risks involved in waiting until December, both in terms of irreversible damage and a sudden event, it seems to be the right choice to go with your local hospital and their earlier surgery date. And, as you point out, they did a good job with your repair 22 years ago, they are a comprehensive valve center and they have been following you for over 20 years.

Wishing you the very best with your upcoming procedure. You are in my thoughts.

Hi

not having had a second opinion I've not had anything to add to your actual question, but this:

dornole said:

So I’m going with the earlier date and putting my trust in my local team that has been following me for 20 years

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sounds like the right stuff

Best Wishes

dornole said:

So I’m going with the earlier date and putting my trust in my local team that has been following me for 20 years and does have a comprehensive valve center.

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Excellent! Please keep us informed. I will pray for you!