Difference between doctors...??

[zztimeout]

I am booked to have my "first" appointment with a doctor to discuss my care. I have BAV and an aorta at 5cm. I googled the doctor and found nothing.. Nothing at all... I did find that he is a Thorasic Surgeon.... Should I be looking for a cardiac surgeon?? Which person would be better with dealing with ascending aorta repair and Alrtic val e replacement??
Im in Australia and have top medical cover and can select my surgeon.. I am so dam confused... If you google a doctor they always come up with something about them...

My uncle who had a vavle rePlacemrnt a few years ago said that the doctor he saw for his appointment was not the guy that held the cutter... It was someother guy that be never saw.... Am I getting worried over nothing ???

 

[ALCapshaw2]

There is a Wide Difference in Knowledge and Skill between CardioThoracic Surgeons depending on their experience dealing with the 'less common' (and more complex) issues such as BAV and Surgery of the Aorta.

You need to know that 90% of Heart Patients have Coronary Artery Disease.
Coronary Artery Bypass Graft (a.k.a. Bypass) Surgery is 'relatively simple' involving placing a shunt 'feeder' (vein or artery) into an external coronary artery.

Heart Valve Disease patients represent roughly 10% of Heart Patients.
Valve Replacement Surgery is more invasive and more complex than CABG surgery.
I'm thinking that BAV patients represent 1 or 2% of Heart Patients
and Aortic Aneurysm patients an even lower percentage.

Aneurysms are often a result of a Connective Tissue Disorder (CTD) that may often be associated with BAV.
Some Doctors are beginning to think that Congenital BAV is also a sign of a Connective Tissue Disorder.

You also need to know that Surgery of the Aorta is more complex than 'mere' Valve Replacement Surgery, especially in the region of the Aortic Arch.

Since you have BAV and an Aortic Aneurysm, it would be wise to ask any and all Surgeons you interview about their experience dealing with those issues, how they would recognize signs of CTD and how they would deal with it. Be sure to also ask about their results (i.e. morbidity and mortality numbers).

Surgeons who deal mostly with CABG and an occasional 'valve job' are not likely to have much experience with BAV and CTD. In the USA, surgeons most experienced with the less common and more complex surgeries are most commonly found at the Major Heart Hospitals.

EDIT - Dave - I'm working on a referal for you. I know someone who would know surgeons in your area.

'AL Capshaw'

 

[Jeff Edmonton]

I had the same issue here in Canada, there is not allot of information on doctors on the Internet. Most doctors in large city University Hospitals are highly trained and they communicate in committees for scheduling surgeries. In my case my cardiologist recommend a surgeon based on my needs and I trusted him.
It is interesting that you bring this up because I think the Internet has actually change the way patients communicate with these surgeons who think they are closer to God then the www.
Stay calm and absorb as much information as you can believe that your life will be better.

To quote Charlie Sheen "Can't is the Cancer of Happen" Humor is the best medicine.

Jeff from the "Great White North"

 

[Jkm7]

zztimeout.....

Heart surgeons are "CardioThoracic Surgeons". You seem to be thinking it is two different categories.
It can seem overwhelming when we first start learning about our heart issues and surgeries but take it a step at a time. Meet with this surgeon, see if you are comfortable with him, take Al's advice and be certain he has done a lot of valve surgeries and not just Coronary Artery Bypass Surgeries (CABG).
Consult with both your cardiologist and your surgeon and learn and ask your questions. If you are confused about something one may say, perhaps someone here has experienced that issue and can help.

We so understand what you are going through, many of us have been in the same 'place' and we get through it and you will too.
This is a highly successful surgery and while stressful and anxiety provoking, it is life saving.
We're here to lend an ear and support you in any way possible.

 

[Lionheart]

timeout,
This is the way it happened for me. Maybe this will help you decide what to do and who to see.
Many years ago during a physical, my Primary care physician detected a murmur and suggested that I see a cardiologist to track it. He sent me to a cardiologist who monitored my heart for about 10 years and then as things got worse he suggested that I have surgery. He set up an appointment with a cardiothoracic surgeon who was associated with him at the local hospital. I consulted with that surgeon about my aortic valve surgery, but I had another hospital provide a second opinion. This second hospital is a world class facility known for its treatment of people with heart disease. During the second opinion process, I decided to have my surgery done at the world-class hospital far from home. To select a surgeon, I called their nurse help line and based on my issues, she assigned me to a surgeon that specialized in those issues. Now, after surgery, my primary doctor monitors basic stuff with my health, my cardiologist monitors my heart health and my new valve, and I have little or no contact with my surgeon since his job is done.

I guess what I am saying is that you should not find a doctor by looking in the phone book or googling on line. Remember the last time you found a plumber that way. It is always better to get recommendations from people that you trust. I think that you should be getting referrals from your other doctors and especially your cardiologist about who the best surgeons are. If you don't like their recommendation, then call the best hospital in your area and talk to them. The hospital should be able to provide you with recommendations for several good cardiothoracic surgeons that deal with your specific issues. Visiting a general thoracic surgeon is a waste of time. Find a surgeon that does the type of surgery that you need and find one that does a lot of them and does them well.

I wish you the best,
John

 

[Mentu]

ZZ, I would suggest that you call the surgeon's office and ask to speak with his surgical assistant. Ask your questions about the surgeon.

How many valve replacements does he performe annually?
What is his experience with Aortic Aneurysm repair?
What is his experience with patients with connective tissue disorders?

The surgeon's office should be able to provide you with this information and if they cannot, perhaps, you should consider caling other surgeons and asking the same questions. These things are not secrets and they are the very basic information that you need to begin selecting a surgeon.

Larry

 

[Duff Man]

Everything Al Capshaw said I agree with. The resection of the aorta is not just your typical valve replacement. It can get complex. I mean, it's already complex, but it can be more complicated than some surgeons have experience or the skill to deal with.

I personally will be at a top rated hospital when it comes time... unless its an emergency. It might be nice to have it done at home, but for the Bentall Procedure and my comorbidities in particular, I'm playing it safe.

 

[scott.eitman]

I will add to Duff Man, at a top rated heart hospital, the surgeons will most likely be top-notch. My view is that at a top rated heart hospital, they can afford to have the best and most likely strive to have the best.

I have found that at the Cleveland Clinic, they have surgeons that specialize in specific procedures and typically very from that area of expertise.

Scott

 

[bdryer]

Hey zztimeout

One of our most stellar star members, "AlCapshaw" is having problems logging onto the forum, so he asked me to do the following post on his behalf:

Al did some digging and contacted an Australian CardioThoracic Surgeon, (from Brisbane) that he knows, who works in the USA at a Hospital which is known for accomplishing Heart Transplants. He asked this doctor to recommend a down under surgeon. The surgeon he recommended is Bruce Garlack. Gathering from my communication with Al, I think it safe to presume Dr Garack is from Brisbane.

bdryer on behalf of AlCapshaw

PS

I initially accomplished this response in another of your posts found:-Update-on-my-aorta