Mayo clinic Dr.

[kbgustavson]

Any comments about Dr. Hartzel Schaff (he will be performing my mom's myectomy this month) at the Rochester, MN Mayo?

[Cynaburst]

Re: Mayo clinic Dr.

I don't know him personally, but he is the head of the Dept. of Cardiac Surgery at Mayo and has been doing these for a long time. Again, if you search his name on the board, you will find lots of people who he has operated on in the past.

Mayo is top notch, and the care at St. Mary's hospital is first rate. I had a great experience there, and I am sure that your mom will have the same.

[amyshields]

Re: Mayo clinic Dr.

I am not familiar with this Dr. either but was very pleased with my Mayo experience!

[anarad]

Re: Mayo clinic Dr.

Hi,
Dr. Hartzel Schaff did my myectomy back in Dec 2006 and recently did my tricuspid valve replacement and mitral valve repair this past June. I have nothing but good things to say for him and his staff. I would have absolutly total confidence with him. When is the surgery scheduled? I live in the Twin Cities. If you have any questions on Rochester or the twin cities, I'd be happy to help.

Good Luck
Kent

[anarad]

Re: Mayo clinic Dr.

Oops....I made an error. My myectomy was in Dec 1996, not 2006. Dr Schaaf has been doing them for some time. Sorry.....

[lazam]

Re: Mayo clinic Dr.

I met Dr. Schaff recently at the Mayo Clinic, and I understand that he is one of the best. He has developed the Apical Myectomy, which is performed only at the Mayo.
Lazam

[Marina C]

Re: Mayo clinic Dr.

What is an apical myectomy? Marina

[Pam Alexson]

Re: Mayo clinic Dr.

Marina ,

Read the article with this attached link. Under operative findings..it will explain the apical myectomy ; which is an extended myectomy down towards the apex of the heart.

http://www.circ.ahajournals.org/cgi/...ull/98/23/2505

Pam

[maryflynn]

Re: Mayo clinic Dr.

My son was 17 when he had his myectomy at Mayo with Dr. Schaff. I was told that he is one of the best in the country. My son has done very well, his gradient is down to 12. I would not hesitate to have Dr. Schaff as a surgeon. The biggest question that I had was that he actually does the surgery instead of the resident physicians. Mayo is a teaching hospital so I wanted to make sure that Dr. Schaff did the actual myectomy.

Good Luck.

[Pam Alexson]

Re: Mayo clinic Dr.

ADDENDUM to my earlier post:

Also there is a rare procedure performed that takes a piece of offeending papillary muscle out via a small incision made in the apex area of the heart. They enter there VS the aorta approach of surgical septal myectomy..BUT it is a rare procedure. As I was reminded to include this type of apical myectomy, could someone if they have the data, please post it so that all could learn..Thank you.

Pam

[Cynaburst]

Re: Mayo clinic Dr.

I don't know if there is any published data about the apical myectomy. I only know about it because when I had my extended myectomy last year (which means that they extend the amount they cut from the top of the septal wall into a trough which begins at the aortic valve and goes a bit further down the cavity, as the article Pam posted described) Dr. Dearani, my surgeon, told me that they might possibly have to make a second incision through the apex of the heart in order to take out all of my obstruction, as I had concentric hypertrophy which means that my whole left ventricle was too thick...not just at the top part of the septal wall where it was causing issues for the mitral valve.

As I understand it, they have only done 40 - 50 of these apical myectomies, and they reserve it for cases where the patient is having very severe symptoms and there is no other alternative besides transplant.

What they do is basically "hollow out" the ventricle so that there will be more room for the blood to fill the heart. In apical HCM, the muscle is too thick down at the bottom of the ventricle, so while there is no regular obstruction and interference with the mitral valve, the ventricular cavity is too small because it is taken up by muscle, so they carve out some muscle so that there is more room for the blood to enter the heart and get oxygenated before it is sent back into the rest of the body.

If anyone else has more detailed info. or data, please feel free to jump in.

[shirleymahoney]

Re: Mayo clinic Dr.

That is the type I have concentric form but the doc said he did not feel comfortable to go down that far so it was left but I was obstructed before the myectomy at the top of my septum also with SAM and then 6 months after my surgery I started having symptoms again and they found that both my ventricles are stiff and now the only thing left for me is a transplant. now I have to get bad enough to be put on the list which I hope never happens

Shirley

[M&Mmom]

Re: Mayo clinic Dr.

Dr. Dearani also performed an extended myectomy for Marissa. She had exceptional anatomy in that the top of her septum (where the myectomy wedge is usually removed) was very thin. She had apical hypertrophy and significant thickening at the left ventricle posterior wall. The muscle had actually grown from the bottom outside up through the left ventricle cavity (on echo it looked like someone had stuck a finger diagonally from the outside bottom corner of her heart like when you put a finger into a ballon). Her obstruction and symptoms were completely debillitating and as most of you know, we saw Dr. Maron in Minneapolis on Nov. 8, and he scheduled her myectomy with Dr. Dearani for three weeks later. After the two days of pre-op at Mayo, we were told the myectomy might not be possible because of her unique anatomy. After significant consultation between the surgeons and specialists at Mayo, Dr. Dearani elected to perform the surgery. His intention was to "hollow out" the muscle as Cynaburst indicated. He noted that in addition to the possible complications, there was significant risk of severing the mitral valve leaflets during this type of extended myectomy as he was going to be removing muscle that had grown right up to the mitral valve. The idea of that type of risk for a 15 year old and what mitral valve replacement would mean for the rest of her life was overwhelming.

The surgery was a great success and the only complication was a minor VSD about mid-septum which has now closed. Her heart had an extreme makeover and to compare the pre-op and post-op echos looks like hearts from two different people.

Most importantly though, Marissa's myectomy in its entirety was completed with entrance only through the aortic valve like all other septal myectomies.