"This is my heart, it's my health, it's my choice."
With these words, Newfoundland Premier Danny Williams defended his decision to hop the border and go under the knife for heart surgery in Florida.
The minimally invasive mitral valve surgery he needed is not available in Newfoundland, he told his province's NTV News channel in the first part of an interview aired last night.
"Did some checking, of course, and what was ultimately done to me, the surgery I eventually got ... was not offered to me in Canada," he said.
But it is available in his home country, a point that cardiologists fervently made last night.
"It's his body, it's his money, hopefully, but don't tell us the operation cannot be done here. It can be done," said Arvind Koshal, director of cardiac surgery at the Mazankowski Alberta Heart Institute in Edmonton.
Some of the best mitral valve surgeons are in Toronto and Montreal, he said, noting that some even use robots, commonly employed in minimally invasive surgery. The wait times for cardiac surgery in Canada are relatively short, he added, saying such surgery could have been done within weeks.
Despite this, research and consultation with doctors led Mr. Williams to seek treatment at Mount Sinai Medical Center in Miami, where patients pay for care.
"I have the utmost confidence in our health-care system, I certainly do," the 60-year-old said, perched on a leather chair in his condominium in Sarasota, Fla. "It's a bum rap for someone to turn around and say, 'Oh, Williams does not have confidence in his own health-care system because he has to leave the province.' "
While Mr. Williams was clear that surgery in his home province was advised against, he was more ambiguous about the Canadian options he explored.
Virtually all heart surgery can be done in Canada, a chorus of cardiologists said earlier this month when they heard about Mr. Williams's cross-border surgery, a decision that launched a debate about private versus public health care.
Wilbert Keon, a heart surgery pioneer in Ottawa and a Conservative senator, said emergency surgery can happen within hours in Canada and urgent procedures done in a couple of days.
For example, the Ottawa Heart Institute offers minimally invasive mitral valve surgery and Hôpital du Sacré-Coeur in Montreal uses robots to repair mitral valves.
Mr. Williams said his heart troubles began more than a year ago when his doctor found a heart murmur and sent him for tests. An echogram test revealed a mitral valve regurgitation "which is in fact a leaky valve," said the Premier, laughing slightly. His cardiologist said his condition was moderate and that it may need a repair or replacement down the road. Another echogram eight or nine months later, before Christmas, elevated his condition from "moderate" to "severe."
The doctor recommended he repair it as soon as possible. Some "soul searching" over the holidays helped him decide a trip to Florida was in order.
Mr. Williams, who went in for heart surgery on Feb. 4, said his father died of a heart attack in his late 60s.
From footage taken in the Premier's sun-drenched condominium last week, Mr. Williams appeared to be the picture of health, telling a reporter he takes multiple brisk walks a day and his arteries are now "as clean as a whistle."
"The doctors have now told me I have the heart of a 40-year-old."