Mitral valve repair

[Rae560]

I need one! 56 year old female in otherwise good health. Does anyone have any info on best doctors for this type of surgery. Have researched Mt Sinai and Cleveland Clinic but it seems that although both facilities are recommended it is still important to pick the right doctor.

[skydnsr]

I agree with valve that there definitely are disadvantages to traveling to a distant site to have surgery.  However, I do recommend getting a surgeon who is expert in the procedure that you need and want.  I did not have any idea how to evaluate a surgeon's experience when I had my aortic valve replacement in 2003,  Unfortunately, the surgeon's experience was less than required.  I had a bad surgical outcome and had to travel to an expert to have the operation redone a year later.  I became much sicker in the interim and was unable to work for a total of 22 months.  For the re-op, I was in the hospital without any family support for 12 days, and I had to fly back home by myself.  That was very inconvenient, expensive, and stressful, but the payoff was that I am still alive, eight years later.  Obviously, it would have been much less inconvenient, costly, and stressful to have traveled to the expert for the first surgery, while I was still relatively healthy and had money in the bank.  I wish I had I only known in 2003 what I know now.  That is why I post on these forums, to try in some small way to help others avoid what I went through with the failed first operation.  If you are lucky enough to live near a very experienced mitral valve surgeon, then there may be little added value in traveling to a distant center.  But if you live in a remote or rural area where there is no surgeon who is regularly repairing large numbers of mitral valves, and you have the means to travel, then perhaps you will be wise to do so.

[Valve]

Im sorry his site is myheartnet.wordpress.com, (no www!)

[Valve]

Rae560,

A colleague of mine has just started a blog at www.myheartnet.wordpress.com and is an expert on the subject! i'm sure he'll answer your questions also,

if you are fit and healthy the important thing is to be absolutely sure you have severe regurgitation before surgery is considered,

if prolapse is the cause, you need to make sure you go to someone that can pretty much guarantee the repair and not replacement, particularly important in robotic is that the anatomy of the valve is well defined beforehand, ask how many surgeries that surgeon has done for your specific anatomy,

there are advantages and disadvantages to traveling away to get the surgery done, the disadvantage being the support system of home is not around you,

[Rae560]

In last echo and stress test mitral valve prolapse severe as well as regurge.  I have spoken to a doctor at CC that does robotic and one at Mt Sinai that seems very accomplished but does not offer robotic. I had a real tightness in my chest for much of the last year-thought it was just stress-but am now on linisiprol(sp) and feel much better so must have been valve related. I can exercise hard with no symptoms and am otherwise asymptomatic and healthy. Really just confused about how to find the best surgeon for my condition.

[Valve]

I take it you have prolapse with regurgitation but can you be a little more specific?

[skydnsr]

Those are both good hospitals, and they both have a lot of good doctors.  I would do research on surgeons and find an experienced surgeon who specializes in mitral valve repair.  I would then schedule an appointment with that surgeon, wherever he is.  If both facilities have a surgeon who specializes in MV repair, then pick whichever one is more covenient.  The surgeon's experience does make a difference, and the surgeon is more important to a successful outcome than the hospital is.  It's not the hospital that will have its hands in your chest, it's the doctor.  A skilled MV surgeon may be able to successfully repair a valve that a less skilled surgeon would have to replace.  The more skilled surgeon will also be better at estimating whether the repair will hold for a good long time.  Good surgeons don't generally practice at bad hospitals, so once you choose your surgeon, the choice of hospital will be made for you, whther it ends up being CCF, Mt. Sinai, or someplace else.  I know CCF has a website listing their surgeons, and the surgeons' bio sketches should give you an idea of their interests.  If the surgeon has been practicing for many years, and he lists mitral valve repair as an interest, then I would consider that surgeon.  Mt. Sinai probably has a similar website, as do many hospitals nowadays.  Good luck.