How to decide on a good Doctor/Hospital

[OLDLADY]

Hey everyone I am new here. After having gone to the ER for a funky heart beat (turned out to be atrial fib) I was told I had severe aortic stenosis a would need a new valve. I had a cardiac cath yesterday and was told the valve was critical. I was sent home told to get on iron supp. for a couple of weeks and get any needed dental work done. I have an appt with the surgeon in 2 weeks to discuss/schedule the surgery. Now I don't know the surgeon, he did say he does lots of valve replacement through a small (minimally invasive) incision. But I got no specifics from him other than he said I probably had a 1-2% risk.
I want to maqke the best choice in doctors/hospitals that I can. I live in NE ga area but can travel if need be. NE ga Medical center in Gainesville ga has been rated the #1 heart hospital in the state for 6yrs. I just want a doc who does this all the time not just once in a while. I have considered getting an opinion from Cleveland clinic. Please, I need advise or info as I am so scared. I know I don't have a choice in this it has to be done but still I am scared. The surgeon I talked with says a mechanical valve would be the best for me since I am 58. Any info welcomed and appreciated.

 

[Lynlw]

Hi, welcome, I'm sure there will be people that know your area soon. I live in NJ, but never heard of NE georgia hosp. I don't know that ranking, but you have to make sure they have alot of exerience in valves, not just CABGs (bypass), If it helps at all, one of the rankings that are pretty respected US NEWs has a couple of different ways of rankings, one is by metro area..I don't know If your anywhere by Atlanta, but that was the the area in Georgia listed http://health.usnews.com/best-hospitals/area/atlanta-ga if you click on the "by specialty" tab one of the rankings is heart surgery.
There is alot of good info here, if you have any specific questions ask away.

 

[epstns]

Hi, OLDLADY (gosh, it feels funny addressing a person that way!) - Welcome to our own little island of insanity. I don't live near Georgia, but I'd bet that if you tell us what metropolitan area is nearest your home, there could be other members who are familiar with the area and would be happy to tell you what they know of the hospitals and surgeons there. You are absolutely right to seek a surgeon who does a lot of valves (preferable aortic), as this surgery is different than bypass surgery, which is more common.

If you're able to travel, you can consider a wide range of truly world-class hospitals and the surgeons who operate there. I know Cleveland Clinic has a remote second opinion service where they will review your records and give you a second opinion without your needing to travel there unless you select them for your care.

I was lucky, living in Chicago. I had several great choices within an hour of my home, and lots of truly great surgeons. Hopefully you will have lots of valid choices, too.

 

[Jkm7]

As you do your research and make your choices, please don't dismiss the idea of tissue valve at your age without reading and learning. A great many surgeons would not bat an eye at implanting a tissue valve in a 58 year old woman. IF you find that is the valve you prefer, you would not likely have resistance from your surgeon.

You're just received very shocking news but you'll adjust to it and move along in doing what you have to do.

All best wishes.
Let us help you in whatever way we are able.

 

[OLDLADY]

Thanks for the info. The doc said at my age (58) a mechanical valve is probably the best. I don't like the idea of taking blood thinners though and was thinking a tissue valve would be the best choice. I am reading all I can find and hope I can come to an educated decision. I live in NE Ga. about 90 miles from Atlanta. I know Emory Hospital is there but they have had issues with MRSA, kinda scary. I feel like I am being hurried into a decision. Docs office called and wants me to come in on the 29th to talk with surgeon and set a date for surgery. I just don't know if he is the right choice. Wen I pull him up on the internet it lists him as a cardiothoracc surgeon but does not list valves as a part of what he does.
Specialties:
•Cardiothoracic Surgery
Most Common Procedures: See How Dr. Wolfe Ranks by Volume
•Lung Endoscopy
•Lung Surface Removal
•Respiratory Tract Intubation
•Surgical Lung Collapse
•Hip Replacement
•Spinal Tap
Dr. Procedures Performed by Rank
Procedures Performed Rank by Volume *
Lung Endoscopy Top 25%
Lung Surface Removal Top 25%
Respiratory Tract Intubation Top 50%
Surgical Lung Collapse Top 50%
Hip Replacement Bottom 50%
Spinal Tap Bottom 25%
I don't see anything about OHS. When I asked if he does a lot of valve surgeries he answered 100s if not 1000s. I want to make the best decision I can and that means finding a doc who has done this many times over not as a once in a while surgery.

 

[piglet]

I was given about 4 days to decide what type of valve to choose. I am 51 years old, have rheumatoid arthritis (which requires immune suppressants) but had no heart issues untill I a bacteria took up residence on my Aortic valve. I chose a tissue valve for 2 reasons, 1) I would not have to take anticoagulants for life, 2) mechanical valve (according to my surgeon, and I stress this point as it is HIS oppinion) are "stickier" his words, so more chance (for me with a comprimised immune system) of reinfection. He also told me that were it not for these reasons he would recomend a mechanical based on thier longevity. I am happy with my choice, and you will need to decide based on MANY factors that pertain to you alone, which choice is best for you. Hope this helps.
GOOD LUCK WITH EVERYTHING ((((HUGS))))

 

[Lynlw]

Have you done a search here for the surgeon to see if anyone used him? Then you could PM them if they dont see your post. From that list it LOOKS like he might be a general surgeon since he does hips etc. I personally would want a surgeon who just does hearts/lungs/chest. Sometimes under the BIO is says their publications etc, that is a good way to see what their specialties are also

 

[drivetopless]

I think I can help you and give you some peace of mind!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I live in Lawrenceville. I had my surgery done in January at NE Georgia Medical Center. Dr. J. Alan Wolfe did my surgery. I got an On-X mechanical aortic valve and only have a 2 5/8" incision. I would recommend you talk with him if you need a second opinion.

IF you are set on a tissue valve, I would recommend you talkt o Dr. Chen at Emory.


I went to Emory, St. Joseph's, and NE Ga Medical when I was searching for a hospital. I was worried about NEGaMC because I had never heard of them. Once I went there for a tour, I felt better. I have to tell you they are the BEST. A lot of Emory and St. Joseph doctors have moved there. The nursing staff is great. My family was treated extremely well. The hospital is run very well. I had a very positive experience. They are on top of things and know what they are doing. The working staff there are happy, too, which I think makes a difference.

If you have any questions, send me a private message and we can chat.

Rest easy--we have great doctors here in Georgia.

 

[Rebecca]

In January of 2011 Dr. Alan Wolf left Saint Joseph because there was talk of Piedmont Hospital taking over Saint Joseph Hospital. Today Saint Joseph Hospital is part of Emory but they still kept their old name. Dr. Alan Wolf and Dr. Edward Chen are the top doctors in Atlanta for aortic valve replacement. Dr. Alan Wolf has done many ross procedures. Dr. Edward Chen is out of Emory in Decatur. See: http://www.surgery.emory.edu/about-us/faculty_directory/edward-chen-cv.pdf

 

[Rebecca]

See Dr. Alan Wolf at: http://www.nghs.com/CardiacServices.aspx?id=2944

 

[Superbob]

Dr. Chen at Emory has a great reputation for valve surgeries.

All best to you in your research and preparation.

 

[OLDLADY]

I actually had my cath done at NE Ga medical center by Dr. Dupont and Dr. Wolfe is the surgeon that came in and talked to me about the critical aortic valve and need for replaccement. I was relieved to see his name pop up on here, it makes me feel better. But, I can't find any statistics on how many aortic valves he does or the short/long outcome stats. Any more people have Dr. Wolfe? Anyone my age choose a tissue valve over a mechanical? In choosing what do I need to be considering? Thanks so very much for all the replys.

 

[piglet]

I'm 51 and I chose tissue.

 

[misaacka]

Anyone my age choose a tissue valve over a mechanical? In choosing what do I need to be considering? Thanks so very much for all the replys.

I'm almost 54, and while my surgery isn't until this coming Wednesday (the 17th), and I haven't yet talked with the surgeon about it, my choice right now is tissue. Like piglet, I don't want to be on blood thinners for life, but more importantly, I believe that percutaneous (through a catheter) replacements will be mainstream by the time my valve needs to be replaced.

Sounds like you have a couple of excellent surgeons to choose from. I live near you, in Greenville, SC, and considered Chen at Emory, but am flying down to Shands at the University of Florida in Gainesville to have Dr. Thomas Beaver do my replacement (flying out tomorrow morning, woohoo!). If I didn't have a dear friend who's a former professor at UF's med school coordinating my care at Shands, I most likely would have chosen someone in the Atlanta area, or possibly at Vanderbilt, where I have family. So many reasons affecting our choices!

 

[OLDLADY]

misaacka, thanks for the reply. You are right there are so many things to consider. I will be 59 in Feb. and the doc says a mechnical valve would last for me. However, I am not fond of the thought of taking thinners for the rest of my life either. And it is not for certain another surgery might not be needed in my future because things do occur which requires it. I have read about the percutaneous replacements and feel you are right, they will be the "thing" at sometime in the future.Did I read that they should be approved for use in the USA by the end of this year? Still would need some history behind them though.
I am thinking of you and your upcoming surgery. I wish you the best of luck and know you will come out feelinh much better. I will say a prayer for you. Please let us know how you are doing. And thanks for taking your time to respond to me, I really appreciate it.

 

[Luana]

Thanks for the info. The doc said at my age (58) a mechanical valve is probably the best. I don't like the idea of taking blood thinners though and was thinking a tissue valve would be the best choice.

I was a bit younger than you when I had my surgery, and I was considering a tissue valve, too. My surgeon said a tissue valve would mean an additional 2 or 3 more surgeries. That pretty much made the decision for me. This is not the kind of surgery you want to plan on having more of. A tissue valve is kind of a crap shoot. You really don't know how long you'll have with it. It may be 5 years; it may be more; there is no guarantee how long it will last for you.

Taking anticoagulants is not difficult and has been about 98% problem-free for me. I freely eat salads and green vegetables and do not restrict anything. Your dose should be adjusted to your diet, not the other way around. Taking a pill once a day is no big deal.

As for minimally invasive, have your surgeon define what he means by that. For some it means a smaller sternotomy. I had an incision done between 2 ribs, on the right side of my chest, so no bones were broken.

 

[OLDLADY]

Luana, The surgeon said it would be a smaller incision in the sternum. I have read about the surgery you describe and that sounds better to me. Where did you have your surgery?

 

[Luana]

I live in southern California and surgery was done locally, Long Beach Memorial Medical Center.