Common sayings are rooted in practical life experience, and the phrase "practice makes perfect" is no exception. The more we do something, the better we get!
In 2003, the New England Journal of Medicine published a special article, Surgeon Volume and Operative Mortality in the United States. It was a report on the outcomes of 8 surgical procedures in Medicare patients. One of those procedures, aortic valve replacement, is important to those with aortic disease. There was further discussion about it in this article also, High surgical volume equals better patient outcomes. Looking at a chart in the NE Journal article, (Table 2), the affect on outcome of the hospital's volume for aortic valve replacement was 0%. The affect of the surgeon's volume on outcome was 100%.
- A woman did not realize she was part of a clinical trial until the hospital contacted her months later for a "free" echo of her prosthetic aortic valve.
- A man arrived home after surgery thinking he had received a certain kind of tissue valve. He had specifically discussed and requested that kind of tissue valve when talking with the surgeon. He was more than a little surprised to discover later that in his chest was a different kind of tissue valve, from a different manufacturer. No one had told him while he was in the hospital.
- A man, still in the hospital, was shocked when the technician told him during his echo that he had a beautiful mechanical valve. He and his family were sure he had requested tissue. No one had told him anything about receiving a mechanical valve until the technician made that comment. If there were technical reasons for the mechanical, no one had explained it to him or his family.
- A woman thought that her ascending aortic aneurysm was replaced with Dacron. When she began to have problems a few months later, in reading her surgery report she discovered that Dacron was not used at all. Her aorta had simply been "shortened". It put her in life-threatening jeopardy as the stitches holding her stretched aorta pulled away from a newly implanted valve.
- A man who had previously had his bicuspid aortic valve replaced required another surgery for a large ascending aortic aneurysm. When opening his chest, his aorta was punctured, causing massive, uncontrolled bleeding. He survived the crisis, but after surgery contracted numerous infections. After fighting for many weeks in the hospital, he lost his battle.
|Dr. Randall Griepp, Dr. Teruhisa Kazui, Dr. Sharo Raissi|
Under his guidance, Mount Sinai developed a rich data resource of results over the years, forming the basis of many important, highly regarded papers on thoracic aortic disease.
The Foundation is grateful for Dr. Griepp's work, and that of other aortic surgeons we have honored, Dr. Nicholas Kouchoukos, and Dr. Teruhisa Kazui. Their work has saved many lives around the world.
|Arlys Velebir and Dr. Nicholas Kouchoukos|