More Information from Need Advice on Surgeon in Virginia

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M

MIF519

To all:
Thank you for your advice and support to date. I realize now that I only gave sketchy information about my condition in my first post, and so I wanted to provide more data for your consideration?

I contracted Rheumatic fever as a teenager. We?ve been monitoring it for the last 42 years (now 56). It?s a biscuspid valve with sclerosis and probably calcification with moderate aortic stenosis and moderate to severe aortic insufficiency. The systolic dimension is 50 mm and the ejection fraction is 45%. Echocardiogram reports that the aortic root is mildly dilated, and the aorta is probably of normal diameter or very slightly dilated. Although the cardiologist has never indicated to me that the mitral valve is a problem, the echo says the mitral valve appears normal with respect to structure and mobility but notes mild to moderate regurgitation. The cardiologist is seeing some signs of heart decompensation as a result of my heart?s enlargement, so that?s why he?s recommending surgery at this time. He said there?s no coronary artery disease, doesn?t see any other aortic problems or complications, and that it can successfully be done by the largest surgical group in this area at INOVA Fairfax Hospital (in the US News and World Report Top 50 Heart Hospitals listing) which handles 80% of heart surgeries in the area. I?ve read that they handle 300 plus valve surgeries a year. I raised the question of minimally invasive surgery and he concurred that he thought I was a candidate on the basis of the single aortic valve replacement.

I had a second medical opinion from a Cardiologist yesterday and he confirmed?Get it done as soon as possible.

I?m trying to schedule a timely appointment with a local surgeon, but I?m still wrestling with the pros and cons of my situation with doing it locally VS going to Cleveland Clinic or similar institution. Again, your advice is appreciated.

If any one has further questions please don?t hesitate to ask In this difficult and confusing time for me, I am glad that I found you.

Regards, Marc
 
There isn't any reason that you can't get high quality care right where you are. In your case, CCF is fine for telling your mind things, but in actuality, you can have it done at home and not have to travel the distance.
 
Hi,
I live in Reston nearby, and am having aortic valve replacement at Inova Fairfax this coming Wednesday (Jan 30--unless this sore throat turns into something worse than a cold:eek: ). I am 60, and only have a stenotic bicuspid valve, no other complicating cardiac or health factors. I just had my presurgery interview/exam at Fairfax Hospital yesterday.
Because I have confidence in both my PCP and Cardiologist, I didn't conduct a surgeon search, but know I have one of the top valve surgeons in the country.
Please read up on "minimally invasive" here and question both your surgeon and cardiologist closely. Especially find out how many of that specific surgery your surgeon has done. Minimally invasive is a term that covers multiple variations of entry points, and is done much more for mitral than aortic replacement.
Please PM me if you would like more information from me.
Debby
 
I understand your requirement for minimally invasive but if you are going for that for an aortic replacement you really need to find a specialist who has done that a lot...they may be a little hard to find.

For me, the thought of doing a great job of my surgery through a tiny hole seemed too big an ask & at the risk of getting this post reported i told my surgeon he could open me up from ear hole to bum hole if it made the job any easier for him....not the exact wording but less likely to get reported..:D

Location is not usually a problem, just finding the right surgeon.
 
"Enlargement" is another Trigger for a recommendation for Surgery. You want to get 'Fixed' before the enlargement results in permanent damage to your heart muscles.

With a Bicuspid Aortic Valve, Dilation of the Aortic Root, and possible Dilation of the Aorta, you REALLY need to see an Aortic Valve / Aorta Specialist with knowledge and experience dealing with BAV and the Connective Tissue Issues often associated with it. I also suggest a Complete Aorta Evalutation (by CT or MRI) because that is the only way to view the entire Aorta. You DO NOT want to replace your valve only to discover that you need to repair your Aorta a few years down the road!

With all of those issues, I'm thinking a Repair is Not likely to be a viable option. Time to read up on Tissue vs. Mechanical Valves. See the Valve Selection Forum and read the "sticky's".

I expect that IF your Aorta and/or Root need attention, that the surgeon will need to do a Full Sternotomy to have adequate access. FWIW, I have 'heard' that a minimally invasive sternotomy is actually more 'uncomfortable' (euphemism) than a full sternotomy. CHEST / sternum pain was WAY down my list of 'discomforts' following my AVR. (Back Muscles was another story! - Thank God for the fast relief provided by MASSAGE!)

'AL Capshaw'
 
The Heart Center at Inova Fairfax Hospital in Northern Virginia is top-rate. I had aortic valve and root replacement (Bentall's) there almost three years ago. I was very pleased with every aspect of my care there, led by the chief surgeon, Dr. Speir, and his team.
 
Marc -- I'm sorry you don't live down closer to Richmond. I would push my surgeon, Tim Wolfgang, on you. He is SO highly rated around here that you'd never have to give a second's thought about going to places like the Cleveland Clinic. I have a link in my sig block.
 
Hello Marc,

I had a great time at Washington Hospital Center :p and I know Innova is top notch too.

You should do great. I wish you all the best.

Ruth
 
Sorry that I am late logging in on this topic. I had my surgery at Fairfax INOVA with Dr. Speir one year ago and the care I received was top-notch. My scar is only 4 inches long and my stay was only 3 days.
My cardiologist is Dr. Chu. He is excellent and has an office next to the hospital.
Good luck!
 
There's no place like home

There's no place like home

There are a good number of top notch hospitals and surgeons in this country spread throughout our 50 states. Traveling for surgery adds a level of complexity and discomfort to the whole process. I don't know about you, but for me there's no place like home. We're lucky here in DC to have Innova, Wash Hosp Ctr and John's Hopkins all within an easy drive. I was so happy to leave the hospital and get into our comfortable warm car and drive through the familiar streets of DC to get home. It was a return to normalcy and a psychological boost that I really needed at that point.

I'm not a good traveler to begin with but IMHO it is well worth factoring in the increased comfort and decreased stress of a local hospital. That said, if you *have* to travel to get the care you need then by all means, of course, you do what you need to do to get better. But, all things being equal, there's no place like home.

I wish you all the best in your upcoming surgery & recovery.

Peace,
Ruth
 
My wife had her surgery done at Fairfax INOVA by Dr. Speir 1 1/2 year ago and the care we received from his team was excellent!. Her surgery was a really high risk case with extensive dissections throughout the entire thoratic aorta. In additiona to replacing her aortic value with a mechinical value, Dr. Speir and Dr. Massimano replaced her entire thoracic aorta with Dacron graft in one operation.
Not only is Dr. Speir excellent surgeon, we found him to be a doctor who truley cares about his patient. You would be in good hands at INOVA...:)


EJ
 
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