Just to add yet another thought about going a long way for surgery. It's easy to get there, not so easy to get back. If you fly, they want you to wait two weeks postop to do so. That means two weeks in a hotel, not comfy home. Two weeks eating out, etc..... If driving, it's a slow, painful drive and again they want you to wait a couple days before leaving the area, depending on how soon they discharge you. Thirdly, coordinating things like post op followup and Coumadin clinic care can be complicated by distance.
I speak from experience. I HAD to go to Cleveland Clinic (had choice of CHOP-Children's of Philedelphia and CC) because my repair was for an Adult w Congenital Defect (ACHD) and pulmonary valve, not common aortic. I had to have a Dr. with lots of experience with adults with heart structures that were all wrong. When I first was led to Dr. Pettersson, I looked at his credentials and thought, WOW, I don't need someone of THIS level, I shouldn't be taking his time, for my repair. Yeah, kinda opposite of many folks thinking. I talked to his RNP to ask about this. I was comforted by her saying if I had a standard AVR repair, no need to come to them as there are many well qualified Aortic surgeons around the country, but my situation was indeed unique and I needed someone on Dr. Ps level.
So from DC to Cleveland we went. I ended up in hospital for 10 days postop because we couldn't get my coumadine level up to range. Because of the distance I was traveling home, they didn't feel comfortable releasing me until I'd reached and stayed at level for two days. They needed me there 5 days early to do their own testing (CT, Cath, ECHO, etc...) as well. That all added up to nearly THREE WEEKS of hotel and eating out bills for myself, hubby and Mom. ChaChing. I don't begrudge the money AT ALL but it can be a factor because that part of expense is not covered by insurance.
Then there was the trip home. Luckily, we have a mini-van and opted to use that for the trip, despite hubby wanting his gas efficient Prius. Even, now, 4 weeks post, I can hardly tolerate riding in the Prius for 5min. For some reason, the vibrations of the car sends my sternum into hyperdrive of PAIN! Ten days postop drive home, was very tiring and slow. I could only tolerate about 4 hours in car, taking Dr. recommended stops every hour for a break to stretch legs to prevent clots. We ended up doing the 7 hour drive home in 2 GRUELING days. HINTS: take biggest vehicle you have, better suspension helps a lot. Extra pillows to cushion chest and to lay on in the car seat. They also recommend sitting in back if you can't turn off air bag. (I can't do this as the back made me car sick within 5min, but we put the front seat as far back as possible and pray we don't end up in car wreck that activates the air bag.)
Anyway, IMHO, Duke is close enough for excellent care and not too far for troubles getting home. If circumstances require the high expertise of a place like Cleveland by all means go, but realize there are issues with the return trip.
Best wishes on your decision, surgery and recovery!
Linda