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Routine scans for heart surgery reveal an arteriovenous malformation

Open neurosurgery — through a wrinkle in his forehead — had him home the same day.

Harry Gaughan, 74, of Ashley, was preparing for major heart surgery at Geisinger when scans revealed something unexpected. A tangle of abnormal blood vessels in the front of his skull, called an arteriovenous malformation.

With his heart surgery behind him, Mr. Gaughan consulted with Clemens Schirmer, MD, PhD, about what to do next.

Quadruple bypass surgery first. Brain surgery next.

Dr. Schirmer specializes in neurosurgery and told Mr. Gaughan he could go in through a small incision in his forehead. It would blend in with a wrinkle, which would correct the problem and have him home the same day, or possibly the next.

The out-of-state surgeon Mr. Gaughan asked for a second opinion estimated he’d be in the hospital for 3 to 4 days. The procedure would be far more invasive, with a long incision and large opening in his skull. “I wasn’t comfortable with that,” says Mr. Gaughan.

So he chose Dr. Schirmer. “I felt comfortable with Dr. Schirmer right from the beginning and really liked what he was suggesting,” Mr. Gaughan says. “Plus, he’s right here in Wilkes-Barre.”

Minimally invasive surgery leaves no visible scarring

The incision Dr. Schirmer made in Mr. Gaughan’s forehead barely left a scar. “He just followed one of my many wrinkles,” he explains. “It blends right in.”

Dr. Schirmer says some patients with arteriovenous malformation can be treated with surgery and still go home the same day. But not all hospitals — or surgeons — offer this type of neurosurgery.

“Not everyone feels they need to push the envelope to bring these kinds of therapies to patients,” Dr. Schirmer says. “And quite frankly, not everyone feels it makes a huge difference whether you go home the same day or stay for 5 days in the hospital.”

But it made a big difference to Mr. Gaughan. He often tells people that he was home on his couch by 7 p.m. after having surgery that morning. He also likes to point to a wrinkle above his right eye to show there’s no scar there.

Nearly 2 years after his surgeries, he’s feeling well, playing golf, fishing and working out in the gym.

“People don’t realize what we have here,” he says. “I have nothing but good things to say about Geisinger. They’ve taken care of me for decades. If anything happens to me, I’m going to them.”

Next steps:

Read and watch more stories
Meet Clemens Schirmer, MD, PhD
Learn about neurosurgery at Geisinger

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