Surgeron does 6 replacements per month?

[Debbie]

Hi everyone, we'll I've had 2 cardio's tell me I need surgery pretty soon and can't decide to go to a big teaching hospital or a smaller private one. I don't want to get into details but so far I'm not at all happy with the interactions I've had with the big one, and the private one has been more than helpful in getting all my questions answered and helping me through this process. Here's the questions, the small one does have a ACHD program and see alot of people. I talked to the surgerons office today to see how may procedures he does. He's in surgery 5 days a week sometimes 2 or 3 a day.He works on about 4 kids a week and 3 adults( most ACHD doc's work on mostly kids). He can do Ross and Norwood procedures and does about 5-7 replacements per month. I really feel more comforatable with a small hospital where I know I can get alot of great presonal care, I know the big teaching one have great doc's but I just don't want to be another number! Also, the small one has magnet status which is the highest award for the nursing. I know excellent nursing staff is very important also. O.K., the question again is, does the surgeon with all the info. from above adequate to do my pulmonary valve replacement?? I'd love lots of input. Thanks Debbie

 

[Lynlw]

Debbie, I would ask how many redos he does( and his succes rate in reops). and how many pulm replacements. IMO,part of the way experience comes in is important in 2nd or 3rd surgeries and the issues like scar tissue that CAN come along with them. Justin's heart is actually fused to his sternum with scar tissue, so it can be very dangerous opening his chest. I personally feel better knowing IF the surgeon runs into a problem, he's "been there done that" and knows what to do and doesn't have to stop and think.

 

[Lisa in Katy]

Living on the edge of Houston, I obviously had plenty of choices of surgeons and hospitals. I opted for the "smaller" hospital based on several things. 1) It was closer to my home and more convenient for my family who would be making the trip several times. 2) I had worked there and was comfortable with the facility and the nursing staff. 3) My long time cardiologist recommended it. 4) Although the surgeon didn't focus on mitral valves, he trained under Dr. DeBakey and had plenty of experience. 5) I felt that a smaller hospital would be more likely to see me as a name and not just a number - kind of the same reason I don't like to shop at Walmart!

Now, when I say "smaller" hospital, I'm not talking tiny. It had about 500 beds then and a successful heart program. Valve surgeries are few and far between compared to other types of OHS and heart procedures, but they still did enough. My surgeon only did 5-8 a month and he was the most active at that hospital. I am very happy with my experience (except for one nurse) and my choice in surgeons. I've had echos by 3-4 techs since the surgery and every single one has commented on the fact that I have absolutely no leakage around the sutures.

Go with the hospital that you are the most comfortable with, especially if you cardiologist recommends it.

 

[tobagotwo]

I'm not sure why this is a question. The smaller place has a thoroughly qualified ACHD surgeon, who is in surgery daily and who is versatile in his surgical capabilities. That last is important, because you want him to look at what's there when he opens you, and not just blindly do a procedure, just because that's what he always does. Plus he's used to seeing deviations that create a challenge to repair successfully. He looks for the unexpected.

And you're looking at a more willing, less abused nursing staff, which is important from the moment you're wheeled out of the OR.

I think you're really just posting to tell us how happy you are to have found a really good and competent surgeon and a great place to have this done...

Best wishes,

 

[Lynlw]

Debbie, I wanted to add, according to the stats at the ACHA clinic listing, which they get from a survey filled out by each center, most of the centers do less than 60 surgeries a year on adults w/ CHD. So 3 adults a week, seems pretty good. Lyn

 

[geebee]

In this area there is a very large hospital that is "the choice" for most people having OHS. I found it to be too impersonal for my liking. My last OHS was done at a hospital that had a fairly new OHS program but with staff that had come from the larger hospital because they wanted to provide more personal care and have the time to do so. My surgeon would have done the surgery in either hospital even tho he was the head surgeon at the smaller hospital.

I have never regretted my decision other than the roofing project that took place outside my window a day or two post op. The smell made me nauseous and my surgeon made sure the roofing project was halted until after I was discharged. Kind of hard to get that level of consideration everywhere.

 

[njean]

. Justin's heart is actually fused to his sternum with scar tissue, so it can be very dangerous opening his chest. I personally feel better knowing IF the surgeon runs into a problem, he's "been there done that" and knows what to do and doesn't have to stop and think.

I can really relate to your concern with your son Justin's situation Lyn; I too have been told by my surgeon's in Houston, basically the same thing. I have massive amount of scar tissue that makes a 4th surgery a very risky situation. You can bet that when & if the time comes, I too will be looking for a surgeon that can say, as you put it, "been there done that". And if that surgeon is not in Houston, which is where I've had all my previous OHS, I will search for that doctor wherever that may be!

Best of luck to you Debbie & go with what you feel comfortable with.

 

[Lynlw]

I can really relate to your concern with your son Justin's situation Lyn; I too have been told by my surgeon's in Houston, basically the same thing. I have massive amount of scar tissue that makes a 4th surgery a very risky situation. You can bet that when & if the time comes, I too will be looking for a surgeon that can say, as you put it, "been there done that". And if that surgeon is not in Houston, which is where I've had all my previous OHS, I will search for that doctor wherever that may be!

Best of luck to you Debbie & go with what you feel comfortable with.

Jean, Justin's had 2 more heart surgeries since the problem started. The 2nd (well technically 5th) one they put him on bypass thru his groin before they opened his sternum. Part of his problem is his heart is very forward and is right next to his sternum actually part of the reason he needed part of his conduit replaced 2 years later was his sternum crushed it.
He had an infection 10 days later and they had to reopen him and were surprised at how much scar he had already built in that amount of time.
BUt the good point is there are surgeons that can open you safely.

 

[Marty]

Ask your PCP who he/she would have for the surgery. Dining room scuttlebut among the doctors often is the best source for a recommendation. I had my surgery locally and have no regrets. I had one doctor friend who went to Houston and another to Cleveland and neither had a good experience.

 

[Debbie]

5 surgerys per month

5 surgerys per month

Hi everyone, thanks for the posts. Lyn good question about the re-do's, I'll ask at my appt. I looked up ACHA list again and this hospital does 60 adults ACHD and works on 200 kids under 18 per year. My orginal question is that I'm trying to understand what is considered a low, average, or high amount of valve surgery's that a surgeron that does these does?? Does that make sense? Can someone reply with some numbers. Thanks alot Debbie P.S. geebee I like your new picture on your posts.

 

[Debbrn]

Dear Debbie,

He may do 5-7 replacements a month. Does that include all valve replacements? How many pulmonary valve replacements per month does he do? Doing a pulmonary valve is different than doing a aortic valve replacement. Lyn is correct. How many pulmonary valve redos he does is important.

I talked to one surgeon's office at UAB and he does 7-10 pulmonary valve replacements per year. I have not talked to the other very active surgeon because I have had some bad experiences with him. I talked to one of the surgeon's offices at Boston Children's who operates on children and adults. He does about 25 pulmonary valve replacements per year.

I am very curious in regards to your docs numbers because I will need another replacement in the next couple of years.

By the way, I do not think that magnet status is all that it is cracked up to be. I am a nurse and work at a magnet hospital. I only would use that status as only one small piece of the puzzle. All it tells me is that the nursing is at least acceptable.

Debbie

 

[MikeHeim]

I had a similar decision in the same geographical area and went with the larger hospital. I was looking to get a complicated mitral valve repair, and was encouraged by my Cardio that if I was really interested in getting a repair, I needed to go to a surgeon that was a repair specialist with a good track record. The downside is that he would often do 3-4 surgeries per day! He was only present for the actual heart surgery, and had nothing to do with the chest opening or closing ? which I understand doctors from smaller hospitals usually do. I only saw the surgeon two times ? once two weeks before the surgery for my surgical consult, and once for about five minutes as I was waking up after it. I was personally of the opinion that since I was having a specialized surgery, I really needed to have it done by the person who had the most experience and expertise in it. Such a surgeon is obviously going to be in demand, so it?s only natural that you?re going to lose some of the personal touch. I would personally talk with my Cardio and ask how ?routine? your surgery would be. Might there be any complicating factors, or is there reason to believe that things should go by the book? Answers to these questions are what will lead you make the right decision for you. Best wishes.