Contributor: Faisal Bakaeen, MD
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At Cleveland Clinic’s Heart and Vascular Institute, we frequently see patients who have been referred to us or who are seeking second opinions — or even second surgeries. We specialize in treating complex cases and performing high-risk surgeries.
We often see:
- People who have had surgery years before and now need a second surgery.
- People who have had operations that did not go as well as planned or whose surgery did not meet intended outcomes.
- People who were previously considered inoperable.
We often tell these patients: Don’t despair if you need a second surgery or have been told you are too high-risk for surgery.
Better outcomes at high-volume centers
It’s been shown that patients who have high-risk factors or who undergo second procedures do best at high-volume medical centers like ours where the surgical and support team have a lot of experience.
At a medical center where many of these type of surgeries are performed, the surgeons have experience in dealing with complex problems and re-operations. When you are referred to a high-volume medical center for surgery, you know that your cardiologist or surgeon cared enough to send you to a place where complex situations are handled on a daily basis.
Getting results with repairs
For example, we commonly see patients who have had a previous valve repair.
Often, the repair appears to be adequate immediately after surgery, but in time the repair fails or does not turn out to be adequate. In many cases, the valve might start to leak or allow blood to flow backwards, which can impair the heart’s function.
We can often re-evaluate and repair the valve again to achieve the outcomes that were hoped for in the first surgery.
Complications and wear and tear
Some patients may have complications after surgery — a heart valve infection, for example — that necessitates another surgery. Medical teams at high-volume medical centers have the extensive expertise to handle patients with these complex types of problems.
Patients who have had a coronary bypass and valve replacement are enjoying longer, healthy lives. Over time, though, even successful valve replacements and coronary artery bypasses may need a re-operation.
Almost one third of the heart surgery operations we do here are repeat procedures. Re-operations are complex and have greater risk than first-time surgeries, but we have successful outcomes with these types of procedures.
Why get a second opinion
Cardiovascular surgeons may excel in specific types of surgery, but they might not have deep experience with complicated cases or re-operations.
If you have been told that surgery is not an option for you or if you need a re-operation, it’s a good idea to get a second opinion from a medical center that has a lot of experience.