How to choose a surgeon?

[paulk]

Hi,

Just joined the forum. My cardio has recommended I get my mitral valve repaired in the next 2-3 months, so now I need to find a surgeon. I'd welcome any advice on how to choose a surgeon, or recommendations of any specific surgeons, I live near Milwaukee, WI. I've heard good things about Saint Lukes, but it is not in my Covenant health care plan. Saint Joseph and Wisconsin Heart Hospital is in my plan.

My biggest concern is repair vs. replacement; I've heard some surgeons are much better than others at successful repairs. My cardio simply states "literature says that 85% of valves like these can be repaired".

Thanks,
Paul

 

[Dennis S]

Suggestion

Suggestion

I asked my primary care Dr. if anyone in his family had ever required OHS. When he said his father had, I asked who he had do it. He said Dr. Kshettry. I asked to see the heart surgery wing at the my hospital (Abott-Northwestern). When I got the chance, I asked a couple of nurses the same question, and the same name kept coming up. I was very happy with the choice.

 

[Kathleen]

Abbott

Abbott

I asked my primary care Dr. if anyone in his family had ever required OHS. When he said his father had, I asked who he had do it. He said Dr. Kshettry. I asked to see the heart surgery wing at the my hospital (Abott-Northwestern). When I got the chance, I asked a couple of nurses the same question, and the same name kept coming up. I was very happy with the choice.

Dennis
I have been with Abbott for 27 years. Wonderful surgeons and cardiologists. I would recommend any of the surgeons at Abbott.
Kathy

 

[blessed1416]

Which surgeon to choose??

Which surgeon to choose??

Paul,
Welcome to this forum. You will find it to be an enourmous wealth of information and support. The people here are like no other- they truly care for you and make you feel special!!

I also had my mitral valve repaired about 3 years ago. I was only 44 and the jest was that if it could be fixed, by all means try that first. Well, here I am 3 years later, and the repair is needing to be replaced. Even though the repair didn't work, I am still returning to the same surgeorn to do the replacement. I've had a few comments from others like: "Well, if he couldn't fix it in the first place, why are you going back to him to replace it?" The answer is simple - I trust him. I did my homework before he ever even touched me the first time. I talked to people who were patients of his. I talked to his nurses. I even talked with a few of his collegues and they all agreed that he was the best. I asked him how many mitral valves he had repaired, and he gave me a one out of 800 (I don't remember exact number) of his repairs that was not successful. But hey, mine worked for 3 years. I would have liked for it to have lasted a lifetime, but it didn't, so now I go in the hospital Jan. 5 for the replacement on the 6th.

Another deciding factor for choosing my surgeon was the amount of surgeries he had done. Again, I'm not sure of the exact number, but he's done many- so many that in our tiny town, I know of at least 12. He's good, but he's also fast. And speed is a quality in OHS. The less amount of time it takes a good surgeon to get your heart out of your body and back in again, the better it is on you. Also, it is to your advantage to be on the heart/lung machine as little amount of time as possible.

So, ask around, keep posting on this site, someone from your part of the world will be in touch with you to help with a specific surgeon. In the meantime I'll be praying that God will connect you with a qualified surgeon and that you will have some peace with the decision you make.

Good luck. Keep us informed about yourself. And may God richly bless you and your family. The time waiting for surgery can be the most trying.

 

[aussigal]

Another newbie Valvereplacement.com member...

WELCOME WELCOME !!

I am a BAVDer (bicuspid Aortic valve Disease) so I do not know specifics of the mitral valve...

I do know you have found the best place in the world for support and compassion here.

 

[Paul117]

another Paul

another Paul

Paul
I just had my Mitral valve repaired on 12/22/05 at St Lukes Milwaukee.
Dr. O'Hair was my sugeon. I am a business man and an engineer and the minute I found out about the "da Vinci Machine" at St. Lukes I checked it out.
(by the way Dr. O'Hair is the guy on the commercial)
I can't be more satisfied with St. Lukes and the staff even though we have our insurance covering both All Saints in Racine (my home) and Aurora I guess I was lucky that way, but don't let the "in network out of network" issue sway you one way or the other. check out the cost differances don't assume that you are not covered because the robotic procedure is not provided by your carrier then you may still qualify.

I was pain free in three days and was discharged from ICU in the same three days. St. Lukes only discharges the robotic patients directly from ICU all the rest stay a few days longer.

let me know what is concerning you maybe I can help with more of your questions.

also check these sights
www.intuitivesurgical.com (the robot maker)
Edwards Lifesciences ( the maker of the repair ring)

Good Luck
let me know

Paul117

 

[paulk]

Thanks everyone for your help. My head is kind of swimming these days with the surgeon decision, it seems sort of like rolling the dice. I met with a 2nd cardiologist today, and he concurred with the diagnosis, but recommended different surgeons. He was not a big fan of minimally invasive surgery, concerned that it kept you on the machine longer. He recommended either St. Lukes or the Wisconsin Heart Hospital. His surgeon recommendations in the Milwaukee area were:

Dr. John Crouch
Dr. Husam Balky
Dr. Daniel O'Hair
Dr. Paul Werner
Dr. Paul Seifert

It was nice he gave me a number of surgeons, my 1st cardiologist recommended only the surgeon in his group, Dr. Reuben. Of the above surgeons, only Dr. Seifert is in my health plan. I meet him Wednesday. I met Dr. Reuben last week, and I'm undecided on him. He has done approx. 200 valves over the last 15 years (is that a lot?), and I was unable to find out how many ended up as replacements. I don't have any personal references for him.

Paul, thanks for your story. I would like to go to St. Lukes, as I've heard good things about it from many people in the area. Unfortunately, St. Lukes is part of the Aurora network, and I am in the Covenant network, which means I would pay a bunch more. Only St. Joes or Wisconsin Heart Hospital is in my health plan.

-Paul

 

[MikeHeim]

Repair vs. Replacement

Repair vs. Replacement

I can't comment on surgeons in the Milwaukee area, but I can comment on one of your other questions. When my cardiologist recommended me for surgery, he said specifically that I should go to Dr. Laks at UCLA. The reason was this: Dr. Laks is well-known for his ability to repair some very difficult valves. My cardio said also said that many surgeons say they like to repair, but the minute they find something they don't like during the surgery they will quickly change the strategy to replacement. I was lucky to choose the surgeon I did because my repair did end up being very complicated. I would assume that your cardiologist would know who has the best reputation for repair work in your area. I'm a little concerned that he seems to have just turned you loose to look for someone yourself.

As far as insurance goes, does your plan have a yearly out-of-pocket maximum? For my surgery, it didn't matter if I used an in-network or out-network doctor because I was going to hit my yearly maximum anyway.

 

[paulk]

I'm a little concerned that he seems to have just turned you loose to look for someone yourself.

Thanks Mike. My first cardio recommended one and only one surgeon. That seemed like a good thing to me. Then I later learned that this cardio always recommends surgeons in his group (he works for a combined cardio & surgeon group). And a number of nurses recommended against him. So I don't know if this recommendation was based on medicine or business.

My second cardio indicated that any of the five are good at repairs, he did have a preference for one of them, but not a strong preference. He had no comment on the other surgeon recommended to me (don't know how to take this?)

Well, today I see another surgeon, and go from there. The things I'll ask him are: how many valve ops, how many mitrals, how many of the mitrals could were repaired. And I will pray that I'm guided to the best surgeon for me.

Man this is stressing me out Thanks for listening!

-Paul

 

[Marguerite53]

Hi Paul. I resemble your predicament! I too am surgeon shopping and working to decide which kind of valve (the aortic, stenotic, must be replaced). I just had my first visit with a surgeon and it was very VERY helpful. (my recent thread is too long winded, but it's there for the reading! My first visit with a surgeon.....) They just come at things from a different angle. Just pick one and get in there for a consultation. Make sure he has all of your necessary papers ahead of time if possible. That first meeting will lay the groundwork for what you will need to make a decision. It should be illuminating. Check with your insurance, mine lets me go for as many second opinions as I want.

Good luck. Keep posting! Do not get stressed out about this part. There are too many cold and flu bugs out there and you will wear yourself out!! Take a deep breath and just dive in!

Marguerite

 

[paulk]

Ok, I met with Surgeon #2 yesterday. A very informative visit. He took probably close to an hour with me and my wife, describing my condition & the procedure to us, answering our questions, and asking me questions.

His first question was "What is your understanding of your problem?". Cool. When I asked him specific questions like "If my valve is calcified, how would that affect the operation?" and "Which leaflet is easier to repair, and why?", were answered clearly, with explanations and expectations provided. He concurred that I should get the op done within the next few months. My wife and I on the walk down the hall quickly agreed that we've found a surgeon.

Then, to make my day I get home, find a message on the machine from my mom who just got back from a doctor visit. She asked her Dr. about surgeon #2 (not knowing I had just seen him that day), and received a very positive recommendation. Just when I thought I was getting nowhere.

His name is Dr. Seifert, and he works in both Waukesha Memorial, and Wisconsin Heart Hospital (I'll be using the later). I'll be making a date as soon as I find out if my pending dental stuff can wait 6 months.

Whew, what a relief to have made the surgeon decision. My anxiety dropped a full notch today! Easily worth 2 smiles! .

-Paul

 

[Cris N]

Paul,
Happy to hear you're satisfied with your choice. I did notice that Dr. O'Hair is on staff at Wisconsin Heart Hospital too. Even though your surgeon feels a repair is probable you should discuss the possibility of replacement if you didn't cover that. My surgeon felt he could repair mine but once he got in he said no way. You mentioned waiting on some dental stuff - anything serious? I think most surgeons want to make sure you don't have any raging bacterial issues going on that might lead to bacterial endocarditis. I had to have my teeth pulled 3 days before surgery.

Cris

 

[Marguerite53]

Hi Paul. Yes. What a weight off your shoulders. I'm very glad that you are pleased with your choice of surgeons. He sounds perfect. Now good luck with the rest of your decision making and please keep posting your questions and decisions.

Good luck! Take some time now to enjoy the moments with your family and loved ones.

Marguerite