Best Doctors 2010: Artistic Touch
Dr. Marc Gillinov’s love affair with the heart began as a teenager when his doctor father gave him a book about the history of heart surgery.
Today, the heart surgeon is writing his own chapter as one of two Cleveland Clinic doctors in the nation’s largest heart surgery robotic program. He performs about 100 robotic procedures annually. “I thought it was just amazing what people could do with the heart, just the notion that you can stop someone’s heart and then start it again,” he recalls. “Right now, in the building where I’m sitting, that’s happening in 15 operating rooms even as we speak.”
Margaret Krzepina never imagined herself in one of those rooms. During a routine exam her internist heard the clicking noise that signals a malfunctioning mitral valve. She showed no symptoms, meaning the valve didn’t need to be replaced immediately. So for six years, doctors monitored her condition with annual echocardiograms (an ultrasound of the heart used to monitor the valve). But then she began to get winded just going up a flight of stairs. “At first, I’m thinking, I know I’m 62, but my God this is a fast change,” she says. “Then I thought, You know what, I bet this is the mitral valve giving up the ghost.”
She was right. It was time for surgery, and Krzepina went into research mode, scouring the Web for information on her condition and sifting through doctor profiles. Gillinov kept coming up in every bibliography and every Webcast of robotic cardiac surgery, a less-invasive but relatively new procedure that Krzepina knew she wanted instead of a valve replacement.
“If you repair a valve, there is probably a little bit more art, a little bit more interpretation and eyeballing and trying to figure out what’s wrong with it,” Gillinov says. He prefers repair to replacement: It leads to better survival rates as well as fewer complications, and it lessens the likelihood that a patient will require long-term use of blood thinners after surgery. It’s generally more complex, he notes, but also more rewarding.
It’s something his patients pick up on, too.
“The other thing that really cemented it for me was that he is very personal, very empathetic,” Krzepina explains.
During the procedure, Gillinov sits at a console with “the best high-definition, 3-D visualization that you can imagine,” he says. There he controls a tiny robot outfitted with metal instruments that performs the repair.
After her surgery, Krzepina attended cardiac rehab and met patients who were still in pain two months after traditional surgery while she was feeling pain-free and getting back to exercising. “It’s a piece of the future,” says Gillinov. “What people need is the least invasive, most effective way to fix whatever’s wrong.”
12:00 AM EST
February 25, 2010