S
Seabush
What do you look for when evaluating cardiac surgeons for valve replacement surgery?
Crystal
Crystal
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M
martha
Dear Crystal,
I think most importantly how many of the kind of surgery you are going to have has he/she done. How long the surgery will be. How long will you be on the pump. If you've decided on what kind of valve you what to have. How comfortable the surgeon is in putting in that kind of valve. Is the surgeon willing to spend time answering all of your questions. Is that surgeon well thought of by his/her fellow physicians. Just a few to start. I'm sure that others will have other suggestions. Hope this has helped.
martha
I think most importantly how many of the kind of surgery you are going to have has he/she done. How long the surgery will be. How long will you be on the pump. If you've decided on what kind of valve you what to have. How comfortable the surgeon is in putting in that kind of valve. Is the surgeon willing to spend time answering all of your questions. Is that surgeon well thought of by his/her fellow physicians. Just a few to start. I'm sure that others will have other suggestions. Hope this has helped.
martha
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Peter Easton
Evaluation criteria
Evaluation criteria
Crystal --
Despite the justifiable warnings mentioned here and there in these forums about "teaching hospitals" and the risk of having large parts of surgery done by interns, one of my criteria for evaluating potential surgeons is their teaching manner. Can they make matters and options clear for me? Are they willing to talk? Do they respond to questions? What is their implicit or explicit attitude about patients who take an active role in researching alternatives and weighing options?
Good luck!
PEter
Evaluation criteria
Crystal --
Despite the justifiable warnings mentioned here and there in these forums about "teaching hospitals" and the risk of having large parts of surgery done by interns, one of my criteria for evaluating potential surgeons is their teaching manner. Can they make matters and options clear for me? Are they willing to talk? Do they respond to questions? What is their implicit or explicit attitude about patients who take an active role in researching alternatives and weighing options?
Good luck!
PEter
G
gary
Selection of surgeons
Selection of surgeons
I 'interviewed' 4 surgeons prior to simple AVR in 1999-2000 in person. I spoke with 4 others by phone during that time.
I vowed that no surgeon would touch a hair on my chest till I have thoroughly had my criteria for selection satisfied AND MET WITH EYEBALL TO EYEBALL.
Yet, after all the exhaustive work I did (which is what I would do again) I wound up choosing a surgeon I never spoke with and never met till I was on the table, 5 minutes before lights out and that for only a minute or two. It greatly assisted me in ruling out rather ruling in a particular technician.
It really depends on the type of interaction you want and if you think that a 'dialogue' with the surgeon will ease your fears prior to and in the months immediately following surgery or, in my case, you're just an insatiably curious person, normally, and especially about the workings of your body and its organs.
I had little fear since I welcomed the surgery after living with this faulty valve for over 50 years. My fear was the imminent heart failure that I thought might occur many times during those years.
I looked forward to the promise of at least 10-12 years of doing things I never could, like running down the beach, percolating at 151 beats per minute, an absolutely forbidden number prior to AVR, and a prescription to keep it up three times a week! The 1% operative risk seemed miniscule by comparison.
My dad (when I finally told him, after concealing my diagnosis till two weeks before the actual AVR surgery) was dumbfounded that I had spent so much time (9 months, almost daily) on the excruciatingly detailed analysis I did whereas, he would have gone in for the cath, and when the cardiologist said we need to operate now, he would have nodded his head and just did whatever the cardiologist wanted. He wants nothing to do with getting any more information voluntarily as I did. He would have cancelled the surgery and just died if he had to do what I did. But he's 86.
I finally decided that I had asked all the pertinent questions of the surgeons that satisfied my curiosity, and most importantly learned the key information I needed to that is very critical to minimizing both operative and post-op risks: 1) Number of surgeries with a particular valve implanted, per year, performed by the Surgeon and his team, 2) average time of perfusion (pump time) 3) on-table 'events' and 4) re-ops and post-op thrombo-embolytic problems.
I was able to use this information to rule out totally all 8 surgeons I spoke with either on the phone or met in person, for various reasons and then selected one I had not met. Mainly because of the time they took, or number of AVR implants with the C-E pericardial valve.
Dr Delos Cosgrove of the Cleveland Clinic met my basic criteria for selection, and as I mentioned I met him only once, on the table where he informed me in no nonsense language about the choices of valve HE would choose, when he finally opened the aorta and looked directly at the site.
I reasoned that a great surgeon probably has little time to meet with potential patients as his time is usually consumed with the many surgeries I hope he has done and thru that all the problems he would have already confronted if trouble arose on the table.
I appreciated the time taken by all including Dr Elkins in OK and Dr David in Toronto and the three here in Pittsburgh who met with me (and one I could have thrown a pie at here at Shadyside Hospital, the arrogant.....) or spoke with me by phone and their candor was invaluable in assessing my risk for a particular procedure.
But nearly all this information was available on the internet at the time and would have been more than sufficient to lead me to the right choice as it did to Dr. Cosgrove.
When I met with Cosgrove for the second time immediately after surgery on his rounds, I was happy I had not met him prior to the 5 minutes before lights out.
His expert handling of the technical aspects of AVR, the profound effieciency of he and his team, his speed and accuracy which are renowned, is as great as his cold, brusque almost anti-patient manner. He's far better with women than men as I noticed when I saw how much more grace and politeness he exhibited with them, particularly those udergoing a second valve implant, than his male patients. Maybe because he has no male children??
Gathering the important information and knowing that Minimizing Risk to near zero or what you think you can tolerate in risk is the primary goal. I chose absolute minimum risk and was able to get over the hurdle of meeting my surgeon face to face provided he did successfully, many hundreds, thousands of very successful surgeries with MY VALVE. All the rest, I learned, was just 'conversation'.
I would have him do it again even though his communication skill was as poor as his technical expertise and AVR knowledge was great.
I hope this helps. If you have any particular questions, you may e-mail them to me at "[email protected]"
Selection of surgeons
I 'interviewed' 4 surgeons prior to simple AVR in 1999-2000 in person. I spoke with 4 others by phone during that time.
I vowed that no surgeon would touch a hair on my chest till I have thoroughly had my criteria for selection satisfied AND MET WITH EYEBALL TO EYEBALL.
Yet, after all the exhaustive work I did (which is what I would do again) I wound up choosing a surgeon I never spoke with and never met till I was on the table, 5 minutes before lights out and that for only a minute or two. It greatly assisted me in ruling out rather ruling in a particular technician.
It really depends on the type of interaction you want and if you think that a 'dialogue' with the surgeon will ease your fears prior to and in the months immediately following surgery or, in my case, you're just an insatiably curious person, normally, and especially about the workings of your body and its organs.
I had little fear since I welcomed the surgery after living with this faulty valve for over 50 years. My fear was the imminent heart failure that I thought might occur many times during those years.
I looked forward to the promise of at least 10-12 years of doing things I never could, like running down the beach, percolating at 151 beats per minute, an absolutely forbidden number prior to AVR, and a prescription to keep it up three times a week! The 1% operative risk seemed miniscule by comparison.
My dad (when I finally told him, after concealing my diagnosis till two weeks before the actual AVR surgery) was dumbfounded that I had spent so much time (9 months, almost daily) on the excruciatingly detailed analysis I did whereas, he would have gone in for the cath, and when the cardiologist said we need to operate now, he would have nodded his head and just did whatever the cardiologist wanted. He wants nothing to do with getting any more information voluntarily as I did. He would have cancelled the surgery and just died if he had to do what I did. But he's 86.
I finally decided that I had asked all the pertinent questions of the surgeons that satisfied my curiosity, and most importantly learned the key information I needed to that is very critical to minimizing both operative and post-op risks: 1) Number of surgeries with a particular valve implanted, per year, performed by the Surgeon and his team, 2) average time of perfusion (pump time) 3) on-table 'events' and 4) re-ops and post-op thrombo-embolytic problems.
I was able to use this information to rule out totally all 8 surgeons I spoke with either on the phone or met in person, for various reasons and then selected one I had not met. Mainly because of the time they took, or number of AVR implants with the C-E pericardial valve.
Dr Delos Cosgrove of the Cleveland Clinic met my basic criteria for selection, and as I mentioned I met him only once, on the table where he informed me in no nonsense language about the choices of valve HE would choose, when he finally opened the aorta and looked directly at the site.
I reasoned that a great surgeon probably has little time to meet with potential patients as his time is usually consumed with the many surgeries I hope he has done and thru that all the problems he would have already confronted if trouble arose on the table.
I appreciated the time taken by all including Dr Elkins in OK and Dr David in Toronto and the three here in Pittsburgh who met with me (and one I could have thrown a pie at here at Shadyside Hospital, the arrogant.....) or spoke with me by phone and their candor was invaluable in assessing my risk for a particular procedure.
But nearly all this information was available on the internet at the time and would have been more than sufficient to lead me to the right choice as it did to Dr. Cosgrove.
When I met with Cosgrove for the second time immediately after surgery on his rounds, I was happy I had not met him prior to the 5 minutes before lights out.
His expert handling of the technical aspects of AVR, the profound effieciency of he and his team, his speed and accuracy which are renowned, is as great as his cold, brusque almost anti-patient manner. He's far better with women than men as I noticed when I saw how much more grace and politeness he exhibited with them, particularly those udergoing a second valve implant, than his male patients. Maybe because he has no male children??
Gathering the important information and knowing that Minimizing Risk to near zero or what you think you can tolerate in risk is the primary goal. I chose absolute minimum risk and was able to get over the hurdle of meeting my surgeon face to face provided he did successfully, many hundreds, thousands of very successful surgeries with MY VALVE. All the rest, I learned, was just 'conversation'.
I would have him do it again even though his communication skill was as poor as his technical expertise and AVR knowledge was great.
I hope this helps. If you have any particular questions, you may e-mail them to me at "[email protected]"
joy
Well-known member
I chose my surgeon when I met him. I actually changed cardiologists once, because I didn't feel comfortable with the first guy. The minute I met my surgeon, I knew he was a good choice. He made me feel like he knew what he was talking about and what he was doing. I think that is how to evaluate a cardiac surgeon. For me, anyways. Good luck!
Joy
Joy
B
Bill Hall
Seabush - I looked for age and reputation. I chose the best rated hospital, Cleveland Clinic and Cosgrove. It turned out that I never did get to meet this guy, but since my valves are working very well now, I guess that didn't matter.
Turkey Hunter
Well-known member
Crystal,
There has already been a great amount of good information given to you.
But, not just evaluating the surgeon's experience, bedside manner, and so on. I think your comfort level with the surgeon is of utmost importance, it was to me. I was also very interested in the surgeon's post procedure involvement. Will they be around more than just the day after your surgery whether at the hospital or available via e-mail or telephone to answer ALL of your questions. My surgeon came to see me everyday following the procedure and I was given his direct e-mail to contact him after I was released if I needed anything.
I also did alot of research and found the procedure and surgeon I wanted very close to home. Although I did not make my final choice until the day before the scheduled surgery.
Good luck and God Bless,
Ben Smith
There has already been a great amount of good information given to you.
But, not just evaluating the surgeon's experience, bedside manner, and so on. I think your comfort level with the surgeon is of utmost importance, it was to me. I was also very interested in the surgeon's post procedure involvement. Will they be around more than just the day after your surgery whether at the hospital or available via e-mail or telephone to answer ALL of your questions. My surgeon came to see me everyday following the procedure and I was given his direct e-mail to contact him after I was released if I needed anything.
I also did alot of research and found the procedure and surgeon I wanted very close to home. Although I did not make my final choice until the day before the scheduled surgery.
Good luck and God Bless,
Ben Smith
