Vascular Surgery in Singapore for International Patients: How to Arrange a Review With Dr Andrew Choong

Dr Andrew Choong is a vascular, endovascular and aortic surgeon at Mount Elizabeth Novena Specialist Centre, Singapore, trained in the United Kingdom and Australia, who treats patients from Singapore and across the region. International patients most often come for three things: a second opinion on an aortic aneurysm or dissection, treatment of a vascular problem that has been called complex or unsuitable for repair at home, and planned treatment of varicose veins, deep vein thrombosis or leg artery disease combined with a visit to Singapore.

The most useful thing to know is that much of the work can be done before you travel. Scans and reports can be reviewed remotely, so that by the time you arrive the questions are specific, the right tests are already arranged, and you are not spending days in Singapore waiting for a plan.

Who travels to Singapore for vascular care?

• People with an aortic aneurysm or dissection who want the scans reviewed by a surgeon who performs open, endovascular and complex (fenestrated, branched, thoracoabdominal and arch) repair, and who can say which option fits their anatomy. See the aortic second opinion guide.
• People who have been told their problem cannot be treated, or only with a very large operation, and want to know whether another approach exists.
• People who had a stent-graft or bypass elsewhere and have lost touch with follow-up, or have been told there is an endoleak or a blockage.
• People with varicose veins, DVT, leg swelling or leg artery disease who want assessment and treatment during a planned stay. See varicose veins, deep vein thrombosis and peripheral arterial disease.
• Dialysis patients with a failing fistula or graft, see dialysis access.

Sudden severe chest, back or abdominal pain, a suddenly cold and painful leg, or stroke symptoms are emergencies: seek immediate care where you are. Do not travel with an untreated emergency.

Before you travel: the records review

1. Send a message. WhatsApp or email the clinic with where you are based, your diagnosis in a sentence or two, your preferred language and when you could travel. The clinic team replies with how to send your records securely. Please do not post records in public comments or chat widgets.
2. Send the records. The CT or MRI images themselves (not only the report), recent scan reports, discharge summaries, operation notes and the make and model of any stent-graft or device, your medication list and recent blood tests. The records checklist lists everything in order of importance.
3. Dr Choong reviews them. For aortic cases this means measuring the aorta himself on the CT, checking the landing zones and access vessels, and comparing with earlier scans when available. For other problems it means deciding whether the existing scan answers the question or whether a new one is needed on arrival.
4. You receive a written provisional view. What the scans show, what the options appear to be, which tests will be needed in Singapore, how long a visit is likely to take and, where possible, what hospital stay would be involved. Where appropriate a short video call can be arranged to talk it through. A final recommendation is only made after a consultation and examination in person.
5. Then decide whether to travel. Many people learn from the review that they do not need to travel at all, or not yet. That is a good outcome.

Watch: What records to send for an overseas vascular opinion · Read: Preparing records for an overseas vascular opinion

What to send, in order of usefulness

What the first visit involves

The first appointment is at Mount Elizabeth Novena Specialist Centre. It includes a consultation and examination, and where possible the duplex ultrasound is done at the same visit so that you leave with a plan. If a new CT is needed, it is usually arranged within a day or two at the hospital, and the result is discussed with you as soon as it is reported. For aortic patients whose records were reviewed in advance, the visit confirms the plan rather than starting from the beginning.

If treatment is recommended and you decide to go ahead, the clinic team arranges the hospital admission, pre-operative tests and anaesthetic review. Dr Choong operates across Singapore's private hospitals; the hospital is chosen with you according to the procedure, your insurer or payment arrangement and your preference.

Hospitals and where treatment takes place

Consultations and scans take place at the clinic at Mount Elizabeth Novena Specialist Centre, 38 Irrawaddy Road, #09-22, Singapore 329563. Procedures are performed at private hospitals in Singapore, including Mount Elizabeth Novena, with the hospital chosen for each patient's needs. Hospitals have international patient offices that help with admission paperwork, letters for visa purposes, accommodation nearby and interpreters.

Estimates, payment and insurance

International patients usually pay directly, and some have international health insurance. After the records review, the clinic team can give a written estimate covering the consultation and tests, and, if treatment is likely, the surgeon's and anaesthetist's fees, the hospital stay and any devices such as a stent-graft. Professional fees follow the published panel-governed ranges. An estimate is as accurate as the information it is based on; it is refined after the consultation, and the clinic tells you clearly what is included and what could change if additional care is needed. See insurance and payment.

Please do not book flights on the assumption that a particular operation will be offered. The review and the consultation decide that.

Language and communication

Consultations are in English. Interpreters can be arranged through the hospital for Mandarin, Bahasa Indonesia, Vietnamese, Khmer, Burmese, Tagalog, Bengali and other languages when you tell the clinic your preferred language in advance. Family members are welcome to join consultations, including by phone or video. Written summaries can be provided for your doctor at home.

Short overviews of this practice are available in:

Any page on this site can be translated into your language using your browser's translate function (in Chrome, right-click the page and choose "Translate"). Automated translation is a reading aid; medical instructions and consent are always confirmed with the clinical team.

Length of stay and follow-up at home

A review-only visit can be done in one or two days. Varicose vein treatment is usually a day procedure with a check a few days later, so a stay of about a week is typical. Endovascular aortic repair usually means two to four nights in hospital and a review before flying, so about ten days to two weeks. Open aortic surgery involves a longer stay and recovery, typically three to four weeks in Singapore. These are typical ranges, not promises; Dr Choong gives individual advice once the plan is known, including when it is safe to fly.

Follow-up scans can often be done at home and sent for review, and the clinic sends a full summary to your referring doctor. For patients after aortic stent-graft repair, the surveillance programme explains what scans are needed and how often.

Common questions from international patients

Can I get an opinion on my scans without travelling to Singapore?

Yes. The records review described above is done remotely, and you receive a written provisional view. A formal recommendation for surgery still needs a consultation in person, but the review tells you whether travelling is worthwhile.

How quickly can I be seen once I arrive?

Appointments are usually available within a few days of enquiry, and the clinic schedules around your travel dates where it can. Tell the clinic your intended dates early.

Will I need a referral letter?

No referral is needed to see Dr Choong. If you intend to claim from an insurer, check whether your policy requires one.

Can my family doctor at home manage my follow-up?

Usually yes. The clinic sends a summary and a surveillance plan, and scans done at home can be sent for review. Where a follow-up procedure may be needed, that is discussed before you leave Singapore.

What if the review shows I do not need treatment?

Then you are told so, with a plan for monitoring at home. A large part of what a vascular surgeon does is advise against operations that are not needed.

Do you treat patients from Indonesia, Vietnam, Cambodia, Myanmar and the Philippines?

Yes. Patients from across Southeast Asia and South Asia are seen regularly, and interpreter support is arranged in advance when you tell the clinic your language.