Comparison of Dr's-- Who do I choose??? MV Repair

[LindaVA]

Hi Everyone. I'm a bit confused and I hope to get some insight from y'all.

I went to two dr's for an opinion on my MV.

The first dr, is the chief at a major facility. He provides very one on one care, will only operate with the same team, and I loved his staff. He also follows you personally and does not farm you off to a cardiologist during your hospital stay. Does minimally invasive mv repair. Looked at my TEE and said it was a complex matter, and he couldn't guarantee repair, but that it was "more likely than not."

The second dr. actually works under the first dr, but at a different hospital under the same system. Not as particular about the first dr regarding his staff, care, etc. BUT specializes in PORT ACCESS and says he is 95-98% sure he can do the repair. He even showed me someone else's TEE which was the same exact as mine, valve anatomically the same shape, and he was able to repair her.

I'm confused. At this A-game level of expertise, shouldn't the first dr be able to do the same repair or are there different skill sets? Maybe Dr. #1 just wouldn't put percentages on it???? I really liked the care at the first hospital, I just am seduced by the 95-98% by Dr. #2! Shouldn't both dr's seeing the same thing be able to have the same result??????

Thanks.
L

 

[Christina L]

I forget how to do it -

I forget how to do it -

but you can get stats from both facilities/surgeons on the outcome of their surgeries and the success rate a few years out from mitral valve repair.

That is why I chose Cleveland - a VERY high success rate by Dr. Delos Cosgrove. However, I still keep my fingers crossed and say lots of prayers three years out.

The WHOLE facility is also very important - they need to be a facility that does LOTS of heart surgeries so there are no surprises at your surgery - they will have "seen it all."

Good luck!

Christina L

 

[maka]

Is the first doctor also a little older than #2? It seems to me that way, and if so, he may have seen plenty to be more cautious with his words.....?more likely than not?....for someone with great experience may well mean 95-98%....knowing that there is always an imponderable beyond his capacity.
I agree the whole facility is very important, as well as the surgeon team.

 

[ALCapshaw2]

Is each (or either) Doctor aware you consulted the other (or any other)?

You may want to consider going back to #1 with the information from #2 and ask him to qunatify his confidence number in %.

And remember, after all is said and done, statistics are just that. It comes down to what he can do for YOU.

I guess I'm just saying they both sound good and there is no EASY answer. Hopefully you will come to a 'feeling' that one is more 'comfortable' to your way of thinking.

'AL Capshaw'

 

[Arlyss]

Approach and Results Depend on an Individual Surgeon's Hands

Approach and Results Depend on an Individual Surgeon's Hands

Surgery is different than some other areas of medicine that might be more "academic" - it involves a great deal of manual dexterity, eye-hand coordination, etc. Especially in more complex areas, not all surgeons use the same techniques. Some of them specialize in some very specific procedures and become very good at them.

Surgeons who happen to work in the same group really may not mean too much in terms of how/what they may offer regarding an individual's surgery. Each surgeon is responsible for his/her own surgery and results, and they will use the technique that they are confident in doing.

I personally would not want a surgeon to "try out" something on me that they do not usually do, just to try to please me and give me what I asked for! I would want them to tell me what they would offer to me as their very best, and I would ultimately have to decide if this is what I want or not. If I want a very specific procedure, I would need to find out who specializes in that and what their results (short and long term) are.

It takes lots of work to research options and obtain opinions, and I wish everyone well in doing it - don't be afraid to ask lots of questions!

Best wishes,
Arlyss

 

[MikeHeim]

I personally would choose #2. I like the confidence and borderline cockiness, which is something I thought was very important for a surgeon. "More likely than not" is far too wishy-washy of a statement for me. In general, I cared much less about any personality traits that the surgeon had than I did about stats he could quote. As far as I was concerned, the surgeon's skill when I was asleep and on the table was the only thing that mattered. The rest tends to work itself out.

Different surgeons have different skill levels and different specialties. Some are quicker to abandon a possible repair as soon as they find something that might make the repair more difficult during the operation. My Cardiologist told me later that most surgeons would have given up and replaced my valve when they realized during the surgery how tricky it was going to be (from reading the operatory report). I'm at almost one year post-op, and it looks like the right decision was made.

Unfortunately, there is no obvious answer and you'll have to go with whatever you're most comfortable with. Best wishes.

 

[distances]

"the surgeon's skill when I was asleep and on the table was the only thing that mattered. The rest tends to work itself out."

I felt exactly the same way. As it turned out, I was lucky enough to like the surgeon as well as feeling confident about his skills. However, I would agree that some hard statistics on past surgeries would be helpful for you in making your choice of surgeons. It sounds like one dr. might be a bit wishy-washy and the other a bit over-confident--even though they really don't know for sure whether to repair or replace until they actually go in, but I think you should have a pretty good idea what to expect. Have you considered a third opinion?

 

[Marty]

I had severe mitral regurg. I picked a surgeon with a lot of valve experience. He said before surgery a repair was likely. When I woke up I had a St. Jude mechanical valve. He said if he repaired my valve he was certain it wouldn't last two years-it was really beat up.( we've had a contributor here on vr.com who had a repair that didn't last four weeks!) I'm eight years out now feeling great and at age 80 not looking forward to repeat surgery. The warfarin has never been a problem for me because of the help I received from Al Lodwick,Ross, and other contributors to vr.com.There are worse things than a mechanical valve. I personally would go for doc #1.

 

[Mary]

I'd go for #1 for the same reasons Marty just gave.