“Should I Go With The Robot For My Mitral Valve Repair?” Asks Doug

Doug sent me a great question about his options for mitral valve repair surgery. In his email, Doug wrote, “I have severe mitral regurgitation and I need surgery.  I’m considering two surgeons…  One surgeon uses the robot and the other surgeon does not.  Which is a better choice for me?”

To provide Doug an expert opinion, I met with Dr. Steven Bolling, the Director of the Mitral Valve Program at the University of Michigan. During our discussion, Dr. Bolling, who has performed over 3,800 mitral valve operations, offered great insight and research for Doug to consider. Here are the video highlights from our chat.

Thanks to Doug for his question and a special thanks to Dr. Steven Bolling for sharing his clinical expertise with our community.

Keep on tickin!

P.S. For the patients and caregivers in our community who are hearing impaired, I have provided a written transcript of this interview below.

Adam: Hi everybody, it’s Adam and we are at the Heart Valve Summit in Chicago, Illinois.  We’re answering your questions that were posted at HeartValveBlog.com.  I’m fortunate to be next to Dr. Steven Bolling, who is the director of the Mitral Valve Clinic at the University of Michigan, Ann Arbor. We have a question that comes in from Doug, Dr. Bolling, he writes, “I have severe mitral regurgitation and I need surgery.  I’m considering two surgeons:  one uses the robot and one does not.  Which is a better choice for me?” (To learn more about mitral regurgitation, click here.)

Dr. Steven Bolling – University of Michigan

Doctor Bolling: “So Adam, first of all, thanks for having me here today.  Doug, the question of the robot, as soon as we hear the word robot, we think cool, sexy, science fiction, space age, so the better question is, not so much the robot, or whether you are having it done through the front or the side or a big incision or a little incision; it’s what the experience of your surgeon, because, Doug, your long term survival will be dependent on having a great repair so you want to get that surgeon who has done the most, who’s done the most experience.  Unfortunately, in the United States right now the average number of isolated mitral procedures per surgeon is only 5 and the average number of robot procedures, per surgeon, is only 3.  That’s sort of like betting on someone to win the Masters who has only practiced golf three times a year, maybe not a great bet.  So you want to go to the most experienced surgeon.  You know it’s not amazing, the more you do something the better off you are on it.  It makes such a difference on someone’s outcome whether they have a repair or a replacement.  Now if that surgeon can do it equally well with the robot or without the robot, fine that’s sort of dealers choice, but you want to be having your repair with the guy with the best, most experienced hands.”

Adam: “And a follow-up question Dr. Bolling… I’m a patient, I come to a surgeon.  They tell me they have done a certain amount but I don’t know anything about what the outcomes are.  How do you as a patient, what do you suggest to patients to get the information that enables them to say, the experience is here, the outcomes are here, I’m going with this surgeon for this procedure?”

Steve Bolling, MD: “Those are the exact questions to ask, for you Adam, and for every patient out there. What is your experience and it is very surgeon specific, it’s not just a hospital or a center.  What is your outcome, and with my problem, and my mitral valve, what is your mitral valve repair rate and you have to expect the surgeon to be honest.  Some of it is published.  There is a lot of very good things on the internet.  But I think to establish that relationship between you as a patient and your surgeon, ask them very honestly, what is your experience with this very particular lesion that I, as a patient, have?  What is your success at repairing this?”

Adam: “So ask those questions, even if they are difficult?”

Dr. Bolling: “I think that’s very important.  Ask the difficult questions, directly to your surgeon.  And if that surgeon is very experienced, he will have the data to tell you those exact numbers.”

Adam: “Great. Well Dr. Bolling, as always thanks for all of your help. Keep up the great work.”

Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

To learn how Adam has helped millions of people with heart valve disease, watch Adam's video, subscribe to his free newsletter, or visit his Facebook, or Twitter pages.

  • Bruce Morris

    Has anyone any experience in the success of physical therapy to reduce dizzieness after AVR? I still have trouble 12months after my surgery with balance . Cheers Bruce J Morris

  • Tim

    Best of luck to you Doug! For me the decision making process was far more difficult and taxing then the actual surgery and recovery. If I may pass along some advice from my own experience and research-please get the robotic mitral valve repair surgery with the most qualified and experienced surgeon you can find. I had mine nearly 2 yrs ago and am so thankful for my experience and my life saving experience I cannot tell you how much I cherish my life, my wife and my 2 small children each and every day (I was only 32 at the time of the surgery)! Good-luck you will do great, please let me know if I can help in any way!

  • Georgia Thiemann

    I also had severe mitral value regurgitation although no symptions. In February 2010, I had surgery performed using the da vinci robot at Hoag Memorial Hospital in Newport beach. It was a difficult decision since I live in Northern California and live 10 minutes from a great hospital and a wonderful heart surgeon but the quick recovery time using the da vinci robot was very important to me. At the time I had surgery, the da vinci robot was not being used for mitral value repair in Northern California. I was in the hospital for four days and then stayed in a hotel closeby for a few days more so I could have the stitches removed where the chest tube had been.

    The day I was released from the hospital my husband and I walked for over an hour in Balboa Island, the next day toured the University of California Irvine. The few extra days we stayed near the hospital was like a mini vacation and I felt so well. When I returned home to Redwood City, I slept well at night, was off all pain medication in a couple of days, started cardiac rehab a month later, and was playing golf again soon afterwards. I am 68 years old and have never felt better.

    As doctor Bolling said, the experience of your heart surgeon and the outcomes is very important and I certainly took that into consideration.

    Good luck with your surgery and picking your surgeon.

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