Donald Thomas had virtually no symptoms when he learned that he would need heart surgery to repair a severe mitral valve prolapse.
The 44-year-old scout leader first discovered a problem when he was required to undergo a physical exam in order to accompany his troop on a hiking trip to New Mexico.
"My doctor found a heart murmur and asked me if I had any symptoms, such as shortness of breath," recalled Thomas. "I had no symptoms that I was aware of at the time. The reason I thought I had no symptoms was because I had no chest pain, shortness of breath, and no fatigue from exercise."
Thomas, a small business owner from Pasadena, Md., had been a runner since high school, but he noticed that in the last year or two it was hard to get his stamina up. "I couldn't run the way I used to. I couldn't do what I could before but I attributed that to getting older," said Thomas.
Once his doctor discovered the murmur, he sent Thomas for an echocardiogram, where they discovered severe mitral valve prolapse. His doctor sent Thomas to see a cardiologist, who said that he would need surgery.
After doing some research, the cardiologist gave Thomas the names of two doctors who were considered to be the best in the area. One was in Chicago, and the other was Dr. James Gammie at the University of Maryland Medical Center.
"I went to see Dr. Gammie and I was very impressed with him," Thomas said. Dr. Gammie ran some tests and told Thomas that he needed to have surgery sooner rather than later. Thomas felt confident with Dr. Gammie because of his extensive experience with mitral valve repair surgery. "Another thing we liked about Dr. Gammie was his history of doing mitral valve repairs rather than replacement," Thomas said.
In the course of doing his own research, Thomas also learned about videoscopic minimally invasive mitral valve repair surgery. "Dr. Gammie was familiar with it and had actually done these surgeries before and could do it in my case if it were warranted. He did tests to see if I would be a candidate," said Thomas. As it turned out, Thomas was an excellent candidate for the videoscopic minimally invasive mitral valve repair surgery.
In fact, Dr. Gammie says the minimally invasive approach is becoming the standard approach. "Currently, for all mitral valve surgeries, this is the favored approach for everyone," Dr. Gammie said. "The only exception is for those who need other surgery at the same time (i.e., a coronary artery bypass). This is our approach for all mitral valve surgeries."
Dr. Gammie says there are many advantages to the minimally invasive approach, including the major advantage of less pain after surgery and earlier rehabiliation, recovery, and return to work and daily activities. "We also think there's less blood loss and a lower likelihood of receiving a blood transfusion," Dr. Gammie said.
Dr. Gammie and Bartley P. Griffith, M.D., chief of Cardiac Surgery at the University of Maryland Medical Center, performed Thomas's mitral valve repair surgery in June 2003. Thomas was happy with the results, and with the care he received at the Medical Center. "I thought I received excellent care at UMMC," said Thomas. "The recovery nurse did a great job."
Dr. Gammie was also happy with Thomas's progress after surgery. "Donald did marvelously well, and he went home in four days," Dr. Gammie said. "He had a very speedy recovery. He went back to work in three and a half weeks, whereas with a more traditional incision, it would have taken eight weeks to recover."
After his surgery, Thomas had no restrictions. "It has not limited my lifestyle," said Thomas. "I could do anything after the surgery that I did before."
Thomas is even running again. "It's a slow recovery but I'm running better now than when I went in for surgery," he said.
In the future, Dr. Gammie feels that the minimally invasive approach will become even more popular for a very simple reason: "It's better for patients and we can do it safely," he said. "We're moving towards smaller incisions for many types of heart operations."
By Michelle Weinstein Murray