Questions for Surgeons

[scuba_898]

Hello everyone, I am going to see a surgeon on Monday and want to make sure I ask all the right questions. A brief background on me...I was diagnosed with BAV in early March (at 28 yrs old) with leakage at Mod to Severe levels, as far as i know i do not have an aneurysm and have since been dianosed with Acid reflux. So I am taking High Blood pressure meds now and meds for Acid reflux. My cardiologist has not told me that i need surgery yet. I am seeing this surgeon as he was recommended from my moms dr., as they are good personal friends (out of state, IL and GA) and this visit is just a visit. so some of the questions i was thinking about asking were

1) do i have an aneurysm? if so what size is it?
2) how often do you perform AVR? what is your preferred method (mech, tissue, repair)
3) how often do you see or work on patients with a BAV?
4) what do i do in the meantime physically?

Those are just a few questions that i can think of off the top of my head i do have a few others, but don't want to ask to many for time sake. I am in the atlanta ga so there are wonderful hospitals and Dr. down here, however being on this site i here so many wonderful things about CC and wonder if having it there is better than here?? I don't know if i should be asking him that question? I have heard that surgeons do get offended on some questions and i certainly do not want to offend him at least not yet.
If yall have any other suggestions on what i should be asking and how to ask it, i would appreciate it. thanks again.

 

[ALCapshaw2]

The BEST way to answer your questions about Aneurisms and their size is to have either a Chest CT or MRI which can visualized the ENTIRE Aorta. Any Doctor can order that test although it would be best to have the results reviewed (and ordered) by either your Cardiologist or Surgeon.

Yes, you have excellent Cardiologists and Surgeons in the Atlanta area.

Emory University (Emory.... Long...? something) is a well known Heart Hospital and is the sponsoring hospital for the NO / LOW Anticoagulation Study with the On-X (mechanical) Valves under Dr. Putkas (sp?) Dr. Chen is their go-to guy for Surgery of the Aorta (i.e. Aneurism Repair with Aortic Valve Replacement).

PeachTree CardioVascular is a Large Surgical Group (see their website) with several excellent surgeons. I've forgotten which hospital they use.

'AL Capshaw'

 

[ALCapshaw2]

The BEST way to answer your questions about Aneurisms and their size is to have either a Chest CT or MRI which can visualize the ENTIRE Aorta (vs. an Echocardiogram which does not provide a good view of the entire
Aorta). Any Doctor can order that test although it would be best to have the results reviewed (and ordered) by either your Cardiologist or Surgeon.

Yes, you have excellent Cardiologists and Surgeons in the Atlanta area.

Emory University Hospital Midtown (Previously: Emory Crawford Long Hospital) is a well known Heart Hospital and is the sponsoring hospital for the NO / LOW Anticoagulation Study with the On-X (mechanical) Valves under Dr. John Puskas. Dr. Chen is their go-to guy for Surgery of the Aorta (i.e. Aneurism Repair with Aortic Valve Replacement).

PeachTree CardioVascular is a Large Surgical Group (see their website) with several excellent surgeons. I've forgotten which hospital they use.

'AL Capshaw'

 

[terryj]

My husband had his AVR at Crawford Long(Emory) with Dr. Puskas. We were very happy with him,his staff and the hospital.

 

[halleyg]

I live close by to you, also in Gwinnett... I had my surgery (MVR not AVR) at Piedmont hospital and they were wonderful. I used Peachtree Cardiovascular Group, Dr. Kauten, who my brother used as well for his MV repair. They operate out of both Piedmont and St. Joe's. I know of a few people who have used both Dr.'s Wolfe and Murphy from that practice and were very happy.
Also wanted to say don't worry about offending, ask away! The more the better. I got three second opinions before my second OHS and one was from the CC...but decided I didn't want to have to travel, my kids were little, etc.
Good luck!

 

[delvalle6]

This may seem like a strange question to ask, but I asked the surgeons I interviewed for my son (the last question) what the "surgeons wish list" would be. In a perfect situation, what would the surgeon want to make both his life easier and your recovery easier. I was surprised that the answers to most of my other questions were given in the answer to that single question.
Since my son is only seven, the surgeon started off by saying something along the lines of "the first thing on my wish list would be that the valve be 21mm".. he then went on to tell me that he would want him as healthy as possible prior to the surgery and would want to control the amount of damage done prior to the surgery.... the three surgeons answered a little differently, but I got clear straight answers. It might be a good question to add to your list. It gave me a chance to see the personalities also.
Good luck to you!

 

[scuba_898]

thanks for all the input guys. I see the surgeon today at 115. hopefully all goes well. however at the same time i kinda just want to get this over with. I know i have not yet had surgery and may not know exactly what i am getting into, but playing the waiting game kinda stinks too. thanks again for your help. I will post later on to let everyone know what he has to say.

 

[ALCapshaw2]

EXPERIENCE Counts.

Be sure to ask the surgeon(s) you interview how many Aortic Valve Replacements he performs annually. Look for someone who does over 100 per year.

Also ask how many BAV patients he sees annually and how much experience he has in recognizing and assessing signs of Connective Tissue Disorder.

If he does NOT recommend a Chest CT or Chest MRI for a BAV patient, I would be 'concerned' since those are the Gold Standard for checking for aneurisms.

Local "Heart Hospitals" that primarily perform ByPass Surgery may have good track records for ByPass but often do NOT perform many Valve Jobs. The Larger Heart Hospitals (Emory University, St. Joeseph, others) would be a better choice for Valve Surgery, especially for a BAV patient.

 

[scuba_898]

hey Al thanks for the additional questioins. unfortunately i didn't get them in time. The surgeon i saw I believe is very experienced. he is with Peachtree Cardiovascular and Thoracic surgeons group and operates out of either Piedmont or St. Joes. His name is Dr. Kauten. I know that he has done surgeries for other members here too. He said he does this all the time, meaning heart surgery. I did not get clarification on exactly how many he does per year, or his experience in recognizing connective tissue disorders. I asked him whats next. He thinks i am to the point of needing surgery. He thinks that i need surgery within the next two months. He is recommending a new cardiologist for me to see and wants me to have a heart cath done preferably this week or early next. I did ask him about the MRI and he said that i don't need one. he reviewed my echo from six mo. ago and said there is no sign of me having a aneurysm. I imagine i will have other tests done too before the big day. This has been a lot to swallow. Last December I got married, February was diagnosed with BAV, and now surgery. Thanks again everyone for your help.