Dr. Craig Miller, Stanford

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JudithD23

Hi,

Well, we're in the process of taking a detour to Tom's OHS. Since the two Dr.s up here have some difference of opinion in how aggressive they would get in their treatment of Tom, we thought we'd get a third opinion and maybe have the surgery done at Stanford, a three hour drive. I should be clearer in my explanation: Our first Dr. thought he would probably not have to replace the aorta, but certainly would if he saw the need. Our second Dr. was relatively sure he would need to replace the aorta and would only leave it in if it looked really healthy.

So we're hoping to get in to see Dr. Miller next week for his opinion and maybe (if it were just up to me I would say probably) travel to Stanford for the operation. Tom is so hesitant to travel far for the surgery. He believes it will be more of a strain on me, and what do you do if there are complications? I argue that if he didn't have a successful surgery, that would be a far greater strain on me, no question. And I've recently read about other surgeries, and bumps in the road, where the Dr. can follow the patient closely without being right there.

So, if anyone has heard of Dr. Miller (and I know someone here mentioned his name) I would greatly appreciate hearing details. I believe at Stanford they do DHCA while in Sacramento hospitals they use clamps. What are the benefits of either process?

Feedback would be helpful. Thanks, Judith
 
Here's what I found from CTS.org (Google Dr. Craig Miller)

D. Craig Miller
Home » Members
D. Craig Miller, M.D.
300 Pasteur Drive
Falk CV Research Center
Stanford, CA 94305-5407
United States

1 650 725-3826
1 650 725-3846 (Fax)

[email protected]

http://stanfordcts.salu.net/staff.html


Institutional Affiliation
Stanford University Medical School, Department of Cardiothoracic Surgery
Specialty
Adult Cardiac Surgery
Peripheral Vascular Surgery
Background
Dartmouth College (1965-1968)
Stanford University Medical School (B.A.1969, M.D. 1972)
General Surgical Residency, Stanford (1972-1975)
Vascular Surgical Residency, Stanford (1975-1976)
Cardiac and Thoracic Surgical Residency, Stanford (1976-1978)
Cardiovascular Surgery faculty, Stanford (1978-current)
Henry and Thelma Doelger Professor of Cardiovascular Surgery, Stanford University
Director, CV Surgical Physiology Research Laboratories
Interests
valvular surgery, mitral valve repair
thoracic aortic surgery
aortic dissections
Marfan syndrome
redo aortic and valvular surgery
endovascular stent/grafts for thoracic aneurysms/dissections
peripheral vascular surgery
 
Here's what I found on the Stanford Physician Search website.
He appears to have the background to do a proper evalutation of your husband's Aorta/Aortic Valve from my (non-professional) perspective.

'AL'

D. Craig Miller, MD
Professor

Make an Appointment

Clinic: Cardiothoracic Surgery
300 Pasteur Dr
A265 MC 5319
Stanford, CA 94305
(650) 725-3826

Fax: (650) 725-3846

Physician Referrals: (800) 756-5000

Office: Cardiothoracic Surgery
300 Pasteur Dr CVRB MC 5407
Stanford, CA 94305
(650) 725-3826

(Note: Picture did not copy - see Standford website)


Specialties: Cardiothoracic Surgery

Sub-Specialties: Aortic Aneurysm
Valve Repair and Replacement
Marfan Syndrome


Professional Education:

Stanford University School of Medicine, Stanford, CA, 1972


Residency: SUMC - Graduate Medical Education, Stanford, CA, 1975
SUMC - Graduate Medical Education, Stanford, CA, 1977


Board Certification:

Vascular SurgeryThoracic Surgery, American Board of Thoracic Surgery

Years on Staff: 30
 
Thanks Al,

I got most of that info also and he certainly has a good vitae. I'm hoping someone can give me a more personal recommendation, or not. As the day goes on, maybe someone will.

Judith
 
Reading his professional record, how does it sound to you, at least on paper?
 
Traveling for surgery.....

Traveling for surgery.....

Judith,

My husband and I traveled eight hours away for surgery at Cleveland Clinic. I understand your husband's hesitancy in going away from home for surgery. However, if the best surgeon for your particular situation is somewhere other than close to your home.........please go!!! In my opinion, it's all about the surgeon's skill and the care you receive after surgery. We are so grateful we didn't accept the opinions of our local doctors.
 
I asked around but my contacts aren't very familiar with West Coast Surgeons.

The Big Names in Aortic Surgery are at The Texas Heart Institute (Baylor), Houston University of Texas, Mt. Sinai in NYC, Univ of Pennsylvania in Philadelphia, and Cleveland Clinic.

Names that were mentioned were Joe Coselli, Joe Bavaria, Lars Svensson (at CC), and Hazim Safi.

A good Question for the Surgeon is whether Tom needs a "simple root replacement" or a "complicated root replacement". Many surgeons can do simple replacements but Academic Centers are preferred for complicated replacements. Aftercare in the ICU is especially important for aortic work and it is important that the ICU nurses have lots of experience with aorta replacement patients.

That's the gist of what I was able to find out from here.

Be sure to ask Lots of Questions of Surgeon #3, especially about BAV, Connective Tissue Disease, and experience with Aorta / Root replacement.

Listen to Rachel. She had to have a 'failed valve implantation' replaced only one year later. She is a staunch believer in going to the Most Experienced and Best Surgeon for the Job the FIRST TIME.

'AL Capshaw'
 
Craig Miller is Awesome!

Craig Miller is Awesome!

Judith - I love to talk about this stuff so get ready for a long entry! I found it comforting to know that there are some serious experts out there that do this type of thing every day. I’ve got some great before and after shots of the CT scan of my ascending aorta to prove it!

First – I can’t say enough positive things about Dr. Miller so if you go with him I know you’ll be in great hands! I probably am bias but I wouldn't hesitate to say that Dr. Miller is the “go to” guy in the West in terms of aortic root replacement. When you’re dealing with the aorta, you want to make sure your surgeon is highly regarded and has tons of experience specifically with aortic root and arch replacement and Dr. Miller fits that bill.

When I started looking at surgeons my goal was to find and meet the very best surgeons I could find for my particular needs and then to go with the one I was most comfortable with. Location I guess had a bit to do with whether I was comfortable with a surgeon but it really was about finding the best at that point. My cardiologist gave me a short list of the very best which included Miller, a surgeon in LA and two others that were out of the country. My cardiologist Dr. David Liang (who is also amazing ) is in the aortic and connective tissues group at Stanford as is Miller so there was already some tight coordination there which was great. Miller was awesome from the moment we met him and we went ahead and picked a surgery date right then and there. I think sometimes you just get a feeling about a surgeon right away and I knew that Miller would be my guy. He made me feel comfortable that he would be extremely thorough and conservative in making sure he removed every part of the damaged aortic tissue so that I wouldn't have to be back in the future. He also made my wife and family tremendously comfortable. That being said, I flew down to LA the very next day to meet another surgeon. The surgeon I talked to in LA was a great surgeon as well but after that meeting I still knew Miller was it. So I went with Miller because of his reputation and experience with the aorta AND because I was so comfortable with him.

I am originally from LA but now live in San Francisco. So it was nice being only an hour away from the hospital after surgery. I was in a good spot because my recovery was either going to be in LA at my parents home or in San Francisco at my own home. But I think if Miller was somewhere farther away I would have gone to where he was. It certainly nice being only an hour away from Stanford knowing that if something happened in the days after I was discharged Dr. Miller was less than an hour away. But I have heard of people that check into a nearby hotel for a day or two after being discharged just for that reason and then fly or drive home after a couple of days when they are comfortable everything is fine. I think if I had had my surgery in LA I would have yearned for my own bed after a week or so and flown back. It may be slightly tiring to travel so soon after surgery and maybe not the most comfortable but I would think it wouldn't be a problem and would be worth it to be home. Other may have different thoughts on travel but that’s my take. I have even heard of people getting discharged and going right to the airport. Open heart surgery is probably a great excuse to cut the lines and pre-board!!

Anyway, say hi to Dr. Miller for me! I think you'll love him - he is awesome as is his whole team. If you do a quick google search for "Craig Miller and aorta" you'll find others raving about him also. And one if his patients (Ronny Turiaf - who had a valve saving root replacement) currently plays for the LA Lakers. There's no doubt Miller is the man!
 
All good news to hear from all of you. We have appointments at Stanford on Tuesday for first an echo then a 64 slice CT scan (which I mistakenly thought Tom had already had) and then we meet with Miller at 12pm for our consult, and of course after reading your posts and then rereading them to Tom, I'm inclined to go with him. None of the surgeons have said anything at all about whether or not Tom has to have his aortic root replaced, but we'll be open when we speak with Miller, and I'm going to print out Al's post so I get it right.

Taylor, I'll say hello for you and send your very highest regards. If Tom feels good about him then we potentially have a surgery date of Friday, the 15th of February. That is so close, but good and good to be in such good hands.

Thanks again, and if we should be asking additional questions, other then the typical questions I asked the first surgeons, fire ahead. You have my full attention.

Judith
 
It sounds like you have found the perfect surgeon, Judith. I hope all goes well on Tuesday and I will put your husband on the calendar for Feb. 15th- we can always change the date if necessary. Look forward to hearing from you again after you meet with Dr. Miller.
 
Judith,
Several months ago, I met someone with Marfan disease who 10 years earlier had his aortic valve replaced with a tissue valve, and shortly after I met this person, he learned he had two very large aortic aneurysms....one in the arch and one in the descending abdominal area. His aorta was already disecting at that time. Dr. Miller at Stanford saved this person's life and performed a very complex surgery to replace his calcified aortic tissue valve with a mechanical valve and resect his entire ascending aorta and aortic arch under deep hypothermia. This extremely successful surgery lasted over 20 hrs and represented the first of two very complex surgeries for this person. The second surgery will be performed shortly and will involve completing the "elephant procedure" and resecting the abdominal aneurysm. Dr. Miller is awesome!
All my best,
MrP
 
Aortic Root

Aortic Root

Judith - You mention that none of the other surgeons mentioned the possibility of replacing the aortic root. I think the root is just the portion of the aorta that is attached to the heart and contains the valve. If the other surgeons mentioned replacing the aorta I think that would include the root. Did the surgeons mention why they would possibly need to replace the aorta? The most common reason I think is the weakening and bulging of the aortic tissue. My ascending aorta was about 4.8 cm when replaced (normal for me would have been around 3 I think). Doctors had been following it really since birth (it's often an unfortunate partner to a bicuspid aortic valve) but it had grown significantly in the year since my last echo prompting them to recommend surgery. The 64 slice CT should give Miller a great view of any enlargement which could necessitate replacement of the root or (like me) the ascending aorta and partial arch. Make sure he or his nurse coordinator Michael prints out the pictures for you. They are really cool. Miller also does a great drawing of what his recommended procedure will be.

Take care, Taylor
 
Hi Taylor,

A rather wordy post, but it's hard for me to articulate Tom's condition and the opinions that we've received.

No one has stated that Tom has a bicuspid aortic valve; the tests to date can't indicate because the valve is too calcified tell. On Tuesday Tom will have another echo and a 64 slice CT scan and hopefully they'll be able to tell at that point. Our first Dr. thought that Tom's valve was probably bicuspid because he's 64 yrs old and the Dr. indicated that Tom was too young to have such a calcified tricuspid valve. This Dr. was inclined to just replace the valve and considered a dilated aorta of 4.4cm as relatively normal for Tom's size (he's 5'11.5" and approx. 217lbs.). But he said he would replace the aorta if it needed it after he was in surgery. On the chest xray Tom's aorta was measured at 4.7cm and on the heart cath it measured 5.2cm. Our second surgeon stated that he would most likely replace the aorta, but that if it looked really good and strong, he would leave it. I think the main thing is to find out if Tom has BAVD and that will determine if the aorta has to be replaced.

Thanks for the web site, we'll definitely study it before Tuesday morning. And thanks for all the information and support.

Judith
 
Phyllis said:
It sounds like you have found the perfect surgeon, Judith. I hope all goes well on Tuesday and I will put your husband on the calendar for Feb. 15th- we can always change the date if necessary. Look forward to hearing from you again after you meet with Dr. Miller.
Click to expand...

Phyllis, thanks so much for your wonderful support for all of us. It's so thoughtful that you keep a calendar for us or our partners crossing over the mountain. I feel like you're one of several mainstays here.

Judith
 
Judith,

I am 3 weeks post-op for surgery involving resection of my entire ascending aorta under 21 minutes of total circulatory arrest and the "repair" of my aortic valve. I travelled over 1000 miles to have surgery by Dr. Sharo Raissi at Cedars Sinai in Los Angeles. As Rachel pointed out, Dr. Raissi is an "aortic specialist" and in addition, in my option, a true humanitarian. I chose him based on his knowledge and expertise in the field of aortic aneurysms but the wonderful side benefit was that is just really an incredible human being. I would not even consider leaving behind an enlarged aorta that was somewhere between 4.7 and 5.3 cm....afterall, who wants another OHS in the new few years?
By the way, replacing the entire ascending aorta and does necessarily involve replacing the root. My root was "remodeled" and not replaced....probably due to the fact that I had a "repair" rather than replacement though.
I guess my point is this....the success of this surgery is vital to the quality of your life and so even if you have to travel thousands of miles go for the best. Your husband only has this one life.....and the hassle of travel is miniscule compared to getting the right care the first time around. I don't know if Los Angeles is closer for you, although it sounds like Dr. Miller is very highly qualified, I would highly recommend Dr. Raissi at Cedars as well!
Take care and all my best to you and your husband. I know for me finding the right surgeon was a huge part of the battle...once that is done it gets much easier!
 
Hi Lorie,

I've been following your progress because I joined the forum just before you were scheduled for surgery. I'm glad you're doing as well as you are and you give us inspiration (how's the pleural effusion?), as does Oaktree (aka......), that the research for the surgeon is one of the most important aspects of a sucessful outcome. At this point in time I've finally gotten Tom to consider Stanford, a three hour drive, in terrible traffic, maybe 4.5/5 hours. I know he wouldn't think of L.A. and we're feeling very good about Dr. Miller. We just need to meet with him on Tuesday.

This forum is wonderful for information, support, and inspiration.

Take care and I'll keep reading your posts.

Judith
 
Judith, All of us, if given the choice, would rather have surgery at home. Alot of us on here, me included, still have children at home. Travelling far from home for a major surgery is not a thrilling thought at all...but I haven't given it a second thought. I want to go to the place where I have access to the Best Surgeon for my problem. Hopefully, your husband will continue to warm up the idea of travelling if that is what ya'll determine is best for him. Good luck!

Kim
 
how...

how...

did it go for you?

we have our first appointment with dr miller on monday, along with the specialized ct. we havent met him yet, but his staff has been so helpful with this process.

i am so thankful to have found this site. its as if since jon was diagnosed with the aneurysm ive become obsessed with learning about the condition. i never thought there would be something as wonderful as this site, to hear from actual patients and their families.
 
hoodie978 said:
did it go for you?

we have our first appointment with dr miller on monday, along with the specialized ct. we havent met him yet, but his staff has been so helpful with this process.

i am so thankful to have found this site. its as if since jon was diagnosed with the aneurysm ive become obsessed with learning about the condition. i never thought there would be something as wonderful as this site, to hear from actual patients and their families.
Click to expand...

Click on "JudithD23" screen name and that will take you to her profile. Scroll down to the "Statistics" section and click on the "Find all threads started by JudithD23" line. That will bring up links to all of her threads, including Post Op recovery and 'bumps in the road'.

If you click on "Find all posts by JudithD23" you will find links to every post written by Judith.
 
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