Cardioligist recommends Surgeon

[mainframe]

How many followed the advice of your cardio in selecting your surgeon? My cardio has said it's time (severe insufficiency) and I ask because my cardio has recommended a surgeon that I might not have considered otherwise.

With my insurance (Group Health coop) there are a couple of hospitals to choose from that are "in network". One of these hospitals has a surgeon (Dr. Hill) that is recognized as being among the best in the area (Top Doc list's for Seattle) and I know of 2 others who have had successful AVR with this doc. This doctor has used the On-X which is my choice.

My cardio thinks that because of an ascending aorta (4.9) that should also be replaced that 1 doctor in particular would be a good choice (Dr. Hall) because of his longtime interest the in aorta. He claimed that if all I needed was a mitral valve that any of the surgeons would be fine.

I plan on chatting with the Dr my cardio recommends but I'm thinking I might like to chat with the other guy too. I do place value in the cardio's recommendation but also place valve in other's experiences and Dr. Hill outstanding reputation.

I’m confused at which way to go.

 

[jax]

I trusted my cardio's reccomendation for a surgeon and after he had referred me to the surgeon I looked up his profile on cleveland clinic's website and was quite impressed. However it is ultimately your decision and there is nothing wrong with talking to whom you want. After all your putting your life in their hands and you need to trust the person that will be doing the surgery.

 

[netmiff]

I think your plan of talking with them both sounds good, then you can make your decision from there. If it's not too cheeky, ask them both what they think of the other!

 

[catwoman]

Chris:

It's SOP for cardios to refer to surgeons, mainly because they usually know some surgeons pretty well and know which types of cases the surgeons are best with or specialize in.

I chose my surgeon after I changed cardiologists (from one in Fort Worth to one in Dallas), and the surgeon was in the same office as the new cardiologist.

By the time my husband needed MV repair or replacement, I had switched back to the Fort Worth cardio after the price of gas shot up. My husband was seeing my cardio and I initiated the surgeon-shopping expedition. We consulted with my surgeon and with Dr. William Ryan, both in Dallas. We let both doctors know that John wanted a thoracotomy, instead of a sternotomy, and a mechanical (probably an Ony-X) should a repair not be feasible.
John chose Dr. Ryan. The cardio has marveled at the incision; at 2 years post-op, you can barely see it. The repair is very good, and no further surgery is anticipated, since it was to repair ruptured chordae.

BTW (1): Our cardio told us to STOP shopping, because the situation was growing critical and we needed to set a surgery date. Doing more consults would possibly cause more damage to the left atrium.

BTW (2): My own surgeon made the Top Docs in Dallas edition of "D Magazine." But that doesn't necessarily make him really a Top Doc. I know that Top Doc lists are sometimes done by peers, sometimes by patients. Neither is totally objective. That's just my opinion as a journalist.

 

[olefin]

My cardiologist recommended the hospital and surgeon.
I had first asked him where he would go and what surgeon he would use, if 'he' or a member of his family was having AVR.

I had trusted his decisions for 10 years and felt comfortable with his answer.

I didn't have all the info available back then for we didn't have the internet in our home.

Wish he was still my cardiologist but after a few years we moved out of state.

 

[tobagotwo]

I think that if the surgeons seem to be fairly evenly matched for experience and activity, that you would look first to the one who is in tune with the way you'd like to have it done.

Which is to say, does Dr. Hall do aorta-and-valve replacements with On-X and graft sleeves, or only with the premade St. Jude units? What about Dr. Hill? Has he done sleeves with the On-Xs?

So, how important is having an On-X to you? (It would be to me.) That may be your decision point.

Best wishes,

 

[Lionheart]

Chris,
You are also going in for a re-operation and I think that adds to the potential complications, so I think that you should also find out if each surgeon has done lots of reops in addition to their experience doing aortic root replacements.
Take care,
John

 

[ALCapshaw2]

With an Ascending Aortic Aneurism of 4.9 cm, THE MOST IMPORTANT Criteria is a Surgeon who has Extensive Experience performing Surgery of the Aorta (either replacement or repair) and recognizing the signs of Connective Tissue Disorder (not to mention knowing what to do if it exists). My understanding is that Surgery of the Aorta is more complex than 'mere Valve Replacement Surgery', especially if it involves the Aortic Arch or if there are Connective Tissue Disorder Issues.

After that, then you can worry about Valve Selection.
(and if you've read my Valve Selection Forum Posts,
you know I am a Big Fan of the On-X Valves).

'AL Capshaw'

 

[mainframe]

Thanks for the feedback. I will plan to chat with both and let thier answers demeanor etc, sort it out. Good questions to ask about the re-op and On-X with graft vs. the St. Jude.

I've only seen the cardiologist 2 times after a switch due to insurance and while I do like him and think he is good, I don't have the the long track record yet to establish the unconditional trust quite yet, but at the same time trying not out think myself. In the end both would probably do a good job I just have to decide whats the best fit for me.

 

[Star54]

I picked my own surgeon based on the fact that he is one of the best doctors in NYC and well awarded and published for anuerysm surgery.
If I would have went with my cardiologist advice (whom I no longer go to), she would have set me up with one of her group.....It's all about the $$$$$ here.