Danny Williams has made no apologies for following what he said were doctors' orders in flying to Miami to have a leaky heart valve repaired. (Canadian Press)

Canadian cardiac surgeons say there was no need for the premier of Newfoundland and Labrador to cross the border for world-class health care.

The treatment Danny Williams received in the United States is available in at least four Canadian centres including hospitals in Vancouver, Montreal, Ottawa and Toronto, doctors told CBC News.

Williams has made no apologies for following what he said were doctors' orders in flying to Miami to have "minimally invasive" surgery earlier this month to repair a leaky heart valve.

However, Montreal cardiac surgeon Dr. Hugues Jeanmart finds that medical advice puzzling.

"I was very surprised, especially for the reason he [Williams] advanced, saying that we didn't have this kind of expertise in Canada, which I completely disagree with," he said.

Jeanmart repairs heart valves using the latest in robotic technology. Instead of open-heart surgery, the operation is performed through an incision under the arm, so there is no large chest scar and there are other benefits as well, Jeanmart said.

"There's less pain, less bleeding, less chance of infection and the main point is faster recovery after these kinds of surgery."

There are also risks, such as stroke, so some cardiac specialists are reluctant to recommend the procedure. But the procedure is still available.

There is a wait-list in Montreal of up to three months, but urgent cases can get the surgery right away, Jeanmart said.

Dr. Alan Menkis, a Winnipeg cardiac surgeon, was a pioneer in using the technology.

Canada can be slow to adopt technology that is expensive when cheaper options are just as effective, Menkis said.

"If you look at the No. 1 centres all over the world, not every single centre in every country does these sorts of procedures. So I would think that the distribution across Canada is not bad. We could do more of that I think."