In 2009, John Stamler was in New York, scheduled for surgery on his sinuses when a routine pre-surgery EKG showed a problem in his heart.
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An echocardiogram confirmed a congenital condition known as atrial septal defect (ASD), a hole between the right and left atrium. Although ASDs are present from birth, there are usually no associated symptoms and the condition can go undetected until adulthood. He still underwent the sinus surgery and then began seeking a physician to repair the ASD.
“Finding out I had a heart defect was a major surprise,” says Mr. Stamler, who was 33 when diagnosed. “I’ve always been very active, running marathons, triathlons and Half Ironman races.”
Mr. Stamler hadn’t been deterred from athletics by his other health condition: type 1 von Willebrand’s disease, a bleeding disorder impacting the blood’s ability to clot. While the disease isn’t life threatening, patients with it need to take precautions with surgeries, tooth extraction and trauma.
Finding the right surgeon
Mr. Stamler, an American currently living in London, met with surgeons in England and the United States, trying to find someone familiar with both conditions. Most recommended repairing the ASD using a catheterization procedure. While this minimally invasive procedure is effective, it requires the patient to take blood thinners for six months — which was risky due to the von Willebrand’s disease.
In March 2010, Mr. Stamler sent an email to Cleveland Clinic thoracic and cardiovascular surgeon Tomislav Mihaljevic, MD, now Chief of Staff and Chairman of the Heart & Vascular Institute at Cleveland Clinic Abu Dhabi.
“From our first email exchange, I knew I’d found my surgeon,” says Mr. Stamler. “He explained that he had previously handled unusual cases like mine and that it was fixable. His prompt and detailed replies made me sure that I’d found the ‘best of the best’ to do my surgery.”
Dr. Mihaljevic recommended repairing Mr. Stamler’s ASD with robotically assisted heart surgery because of his von Willebrand’s disease.
Less invasive, less traumatic surgery
Robotically assisted ASD surgery is performed through small incisions made in the right side of the chest. The surgeon’s hands control the movement and placement of the endoscopic instruments, which are used to retrieve a small patch of pericardial tissue. The pericardium is the thin sac that surrounds the heart. The tissue patch is used to repair the defect between the right and left atrium for ASD defects.
Compared with traditional surgery, the benefits of robotically assisted surgery include smaller incisions with minimal scarring and less trauma to the patient, including less pain, shorter hospital stay, decreased use of pain medications, less bleeding and decreased risk of infection. Patients also experience shorter recovery times and quicker return to daily and professional activities.
An amazingly quick rehab
Three weeks after his surgery, Mr. Stamler was back at the gym. Working with a physical therapist, he began following a prescribed plan of treadmill running and cycling while wearing a heart rate monitor.
“It felt a bit odd running at a very moderate pace and watching my heart rate go higher than normal, although not abnormal,” he says. “I wasn’t nervous, but I listened to my body if things did not feel quite right.”
After two months of increasingly challenging rehabilitation, Mr. Stamler, under the watchful eye of his physical therapist, quickly swam several laps and then climbed the steps out of the pool while holding the railing — to be sure the blood flow in his body easily transitioned from horizontal to vertical in a short period of time. Mr. Stamler passed the test with flying colors and was cleared to resume his normal activities.
A marathon less than six months after surgery
Less than six months after his robotic surgery, Mr. Stamler ran the New York City Marathon with a time of 3:36:50. His goal in participating was to help raise awareness of Ben’s Friends, an international organization dedicated to creating a network of online support communities for individuals with rare diseases.
“In addition to the stellar medical care I received at Cleveland Clinic, finding a Ben’s Friends online community and receiving support from others like me was very powerful and inspirational. It’s something I highly recommend,” Mr. Stamler says.
“I am beyond grateful for everything Dr. Mihaljevic, his team and Cleveland Clinic did for me,” says Mr. Stamler, who has supported the Sydell and Arnold Miller Family Heart & Vascular Institute and Dr. Mihaljevic’s research. “Choosing to have surgery there under the care of Dr. Mihaljevic was the easiest decision I have ever made.”