Meeting the Surgeon with the Magic Hands

One 11Feb at 2130 (9:30 PM) Lynne and I spoke to Lowell Satler MD, head of a the Interventional Cardiology Department at Washington Hospital Center, the one who will do my surgery. He had a dinner engagement that night, and offered to call us afterward. Nice guy. He patiently answered all my engineer questions until 2200.

They have done the PFO Closure surgery for 15 years and average 35-40 per year.

The risk profile is
1/1000 die
1/100 bleed
1/100 have stroke.

Overall 85% of patients have complete closure afterward.
1/30,0000 have the device fail and cause a big problem
The device used is an Amplatzer which has a long history in heart repair

The recovery:
Surgery on Friday 26FEB
Return home the next day
Return to work as early as Monday
Exercise in 3 weeks
No elective surgery for 6 months
The only long term medication would be a baby aspirin

The recent CLOSURE Trail reported that closure and long term medications were statistically equally effective. The doctor recommends that the surgery is good for me because I am in the ideal class for the surgery (young, multiple stroke events, hole in heart (PFO) WITH aneurysm) and that he believes that future trials will show greater efficacy for the surgical route. In particular he noted that an update from the above trial just came out that showed increasing benefit for the surgery group compared to the medicine group. He also stated that it is very difficult to analyze a rare event (~3% occurrence) because you need very LARGE populations to have valid statistics. A couple outlier events can skew the data significantly. He related that the lungs actually work as large filters for small clots. Without the hole, little clots are captured by the lungs and are redissolved without harm.

The nature of the partnership with Cleveland Clinic is one of likemindedness.  The Cleveland Clinic wanted to develop a network of hospitals with comparable ability and quality in heart repair. It is positive that Cleveland Clinic considers Washington Hospital Center on par with it.  They don't interoperate or work together on projects, though they are available to each other.

I will be part of a training exercise. Don't worry, no rookies would be touching me, just the experienced doctors. There would be three other rookies in the room learning how to do the procedure. In that sense, it is encouraging that the doctors at WHC are those being sought out as experts within the community.