AVR Surgery

[IanH]

Hi all,

I have been browsing this great forum for the past few weeks since I found out my surgery was pending and thought it was time to introduce myself.

My name is Ian. I am 48 and live in Victoria, BC (Canada). I have a BAV with aortic root dilation and severe aortic regurgitation. I've known about the BAV for 25 years but the aneurysm is a fairly new development to me at least. At my last cardiologist appointment he said the echo showed that my aortic root dilation was "at the cusp" and he sent me for an MRI. The MRI confirmed his concerns and I have since had an angiogram on Dec. 23rd and have had my first consult with a cardiac surgeon.

My surgery has been set for February 12. After discussion with the surgeon and my research on this forum as well as other web sites we have decided to go with the "Bentall" procedure and replace the valve with a SJM mechanical valve and a dacron tube graft conduit. I am having trouble finding much information on the Bentall procedure though.

I am curious about the differences between the American and Canadian medical systems. I see a lot of discussion about choosing surgeons. Here it seems that we are referred to surgeons. It is possible to change your surgeon but it isn't easy (I have some experience from when my son broke his arm). Luckily I am comfortable with the surgeon I was referred to and he seems to be pretty good too. If anyone has any comments I would be interested to hear them.

I would like to thank everyone in this forum for the information I've already gotten by lurking. I am sure that in the next few months I will be using this forum to great advantage.

Ian

 

[Curtsmum]

Hi Ian, i can't answer your questions but just wanted to say welcome and all the best with your surgery.

 

[hall]

Hi Ian. Welcome to the forum. There is a wealth of information here so if you ask a question, someone will come along and help. Sorry, I can not answer your question.

 

[pamela]

Ian, Hello from the other side of the mountains, literally and figuratively. Welcome.

If you'd like a second surgical consult simply ask your surgeon. There isn't any real competition for "customers" in Canada and so you can ask any doctor on your team to refer you. Be warned, though, that this may cause delay in actual surgery dates because you will:

• wait for an open appointment,
• possibly be required to travel and unless you can justify to your Provincial plan that it's absolutely neccessary, then you will foot the bill and
• conceivably wind up at the first surgeon and have to wait for an opening on his list.

Keep in mind though that it is your right to have whichever qualified surgeon you wish work with you to perform your required surgery but no one can guarantee that this is the most efficient route to the OR.

Take Heart, everyone wants to make you better,
Pamela.

 

[vprnet]

Hello Ian and welcome.

Here in the US it all depends on your insurance situation or how much money you have. With enough money you can likely chose any surgeon. But if money is a factor (as it is for most of us) you will be limited to the doctors that will accept your insurance plan or will agree to take it and perhaps charge for the difference.

Fortunately there are many excellent doctors in the US that will work with ones insurance and financial situation. But this requires searching, consultations and referrals. It can be a lengthily and tiring process.

Luckily for you, you have been "given" doctors you are happy with and you seem to be well enough informed to make that assessment.

Differences between the Canadian and US medical systems is a point of heated debate on both sides of the border. But to be sure, here in the US it needs to be fixed and our medical professionals need to be better compensated for the life saving work they perform and personal sacrifices they make to do it.

Best wishes for your upcomming surgery.

Vincent
BAVR with 27mm ON-X NYP Weill Cornell Dec 19, 2008.


PS. I am not a medical professional or a doctor. My comments in this forum are my own opinion and are not intended to be given as medical or professional advise or a recommendation of any valve choice. Decisions that affect your health and wellbeing are ultimately yours and your doctors. vprnet

 

[Cameron]

Hi Ian and welcome from over the Straight.
I will be having an AVR next Monday at St. Paul's. In my diagnostic process I was aware of the professional connections that there were between the doctors I saw and those that they normally refer people to, and after my angiogram I got quite a hard sell on who I should go to for surgery. However, I already knew who I wanted and I just kept telling everyone that in a calm, firm voice! I did get referred to whom I wanted, but as others have pointed out, I think I have ended up waiting a bit longer to get on my preferred surgeon's "cut list" as he is a very popular guy!
Just remember that they don't let just anyone do this stuff and that anyone they suggest will be competent and what you end up with will be way better than what you have now!
Good luck on the journey!
Cameron

 

[ALCapshaw2]

Welcome Aboard Ian !

The KEY Question for you to ask your surgeon is
"How much experience do you have performing the procedure I need and, What are your results"?

If you are happy with his answers and feel comfortable with him, there is probably not much need to look elsewhere.

Have you done a "Search" on VR.com for the Bentall Procedure (see the Blue Line at the top of each page, click on search, and type in "Bentall").

Similarly have you done an Internet Search for "Bentall" using Google or one of the other Search Engines?

'AL Capshaw'

 

[ALCapshaw2]

Welcome Aboard Ian !

The KEY Question for you to ask your surgeon is:
"How much experience do you have performing the procedure I need and, What are your results"?

If you are happy with his answers and feel comfortable with him, there is probably not much need to look elsewhere.

Have you done a "Search" on VR.com for the Bentall Procedure?
(see the Blue Line at the top of each page, click on search, and type in "Bentall").

Similarly have you done an Internet Search for "Bentall" using Google or one of the other Search Engines?

'AL Capshaw'

 

[Cooker]

Welcome Ian .... I'm glad you found us ... there is a lot of information here and the support if the members is second to none ... I wish you well on your surgery.

 

[Phyllis]

Welcome, Ian. I'm glad you found us before surgery and I am sure you will acquire a wealth of information in the weeks ahead. I put you on our calendar, so it is "official"!

 

[ottagal]

Hello fellow Canadian,
Welcome to this great site. Unfortunately, I can't help you with your question re: Bentall procedure, but glad you joined us and that you are happy with your surgeon choice.
p.s. had a great visit to Victoria this past October and just loved it!

 

[WayneGM]

Welcome to VR. Glad you found us. Since I'm Canadian, and can't I provide insight on the American medical system. However, although I didn't get to choose the surgeon, I lucked out and was referred to Dr. Tirone David in Toronto who is considered one of the best in the world. There have been several threads on the costs of OHS and I thank my lucky stars for being in Canada and having it all covered by our government health care system. Coupled with my employer health insurance to cover the private room and post-op prescriptions, I didn't pay for anything except the TV in the room. Best wishes and good luck with your surgery.

 

[IanH]

Thanks to everyone for their replies and compassion. This site is a wealth of information and everyone really seems to care. In my lurking I didn't realize how well represented Canada was on this site.

I have looked up "Bentall" on both this site and on google and found some good information. I have also found out more on the Canadian medical system with everyone's help. I have come to grips with having surgery on Feb. 12 and think that if I were to change it would cause more stress that I don't need. Luckily I am comfortable with my surgeon and his ability and knowledge so I don't feel the need to change doctors at this time.

Ian

 

[Buffy41]

Hi Ian,
I have the exact same problems as you and will be having surgery on Thursday at Royal Colombian in New West. This whole process is very stressful. You've come to the right site.

 

[Eva]

Ian,

Welcome to VR and good luck!

 

[Adrienne]

Here in the Province of Quebec, we can ask for a referral to whatever doctor we want or whatever hospital. However, the wait can be very long!!!

 

[netmiff]

Welcome, IanH; maybe us Canucks will take over VR.com someday

Our heart surgery centre is out of town, about 45 minutes away, in Hamilton. My cardiologist (who is local) asked me if there was a surgeon I preferrred, I said no, I'm not familiar with any cardiac surgeons (who is, until you need one ??), so he then asked me what qualities I would like in a surgeon (and I assumed he meant apart from surgical qualities, 'cos I don't think he'd send me to a quack). I said someone with a bit of humour and who will work with me, take my point of view into sonsideration (I don't do well with people with god complexes in general). So, he said I know just the man, he went to medical school with me (gave me an idea of his age, young enough to remember his lessons and have kept up with new advances, old enough to have a decent amount of experience). So, I ended up with Dr. Semelhago, and was very happy with him.