thank you for your advice. you mentioned you were a vascular surgeon. I am seeing a vascular surgeon here at univeristy of miami, but he hasnt had much experience with first rib resections. he told me he has done over 10. A close friend was a fellow of Dr Donahue, whom I have spoken to personally and based on peoples comments in this forum, I trust him. I should hear from him today on his opinion. I am willing to travel for this surgery since I am aware of the complicatins and understand only a skilled surgeon with experience should be performing it.