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thos_huxley

Member
Joined
Nov 2, 2018
Messages
5
Location
Illinois USA
Hello all. . . .

Although this is my first post to this forum, I've lurked here for some time, reading and gathering information preparatory to OHS for a modified Bentall procedure. A change in my personal situation prompts me to ask for help.

My medical condition is bi-leaflet aortic valve (fused and proloapsed cusps) with a dilated aortic root (at the moment, 4.8 cm). To keep my heart strong, I swim 40-50 minutes three times a week. I get an MRA and ultrasound once a year at the Bluhm Cardiovascular Institute (Northwestern Memorial Hospital) in Chicago. So far, the aortic dilation has been stable and hasn't grown for three years, although when this all began around 10 years ago, the measurement was 4.2.

While I've been very pleased with the care and attention I've received at Bluhm, my personal situation will be changing in the near future. That is, I'm moving to western Kansas, so I'll need to find a new cardiologist and thoracic surgeon. Presumably I'll go to the University of Kansas Hospital, which U.S. News & World Report ranks #24 for cardiology and heart surgery. Frankly, that choice doesn't look very good when you've been visiting a top-10 care center. There's also St. Luke's Hospital, which is ranked even lower.

Of course I realize a surgeon's experience and skill is the most important priority and consideration, so I'd like to get some advice and/or recommendations from anyone who has first-hand experience at one of these Kansas hospitals.

Thanks in advance to all who respond!

TH
 

pellicle

Professional Dingbat
Joined
Nov 4, 2012
Messages
6,156
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Queensland, OzTrayLeeYa
Hi and welcome

...Presumably I'll go to the University of Kansas Hospital, which U.S. News & World Report ranks #24 for cardiology and heart surgery...

Of course I realize a surgeon's experience and skill is the most important priority and consideration,
While I'm sure that's important, the rest of the team and the hospital's issues like anestherist, infection control, ICU, diligence of general nursing ... are as important.

How many States are there again in he USA? How many countries in the developed world?

With that in mind hundreds of thousands of these surgeries are done across the globe yearly and it's not like there is only one well done operation per year. It's not that sort of a competition.

Surgeons are by nature super self confident and would of course want you to believe they alone can do the best job. However the reality is that this surgery is globally the most successful medical intervention of the surgical repertoire means it gets done pretty well all round the world and across America.

I hope your surgery is event free and your recovery smooth.

Best Wishes (from an Australian who has had three operations, none of which were done in US hospitals)
 
Last edited:

Duffey

Me and Granbon
Joined
Sep 29, 2004
Messages
5,051
Location
Far side of the moon
Are you considering the change of cardio and surgeon due to insurance network coverage? I would ask Northwestern who they recommend. Another thought, maybe find a new cardiologist and keep the cardio thoracic surgeon in Chicago (insurance willing). Is Denver an option? I understand your reluctance to make the switch. I can’t recall anyone saying they’ve had surgery in at a Kansas located hospital, but you might try starting a new thread and ask about Kansas in the title. Good luck and best wishes.
 

tom in MO

Well-known member
Joined
Jan 17, 2012
Messages
999
Location
MO USA
Hello all. . . .

Although this is my first post to this forum, I've lurked here for some time, reading and gathering information preparatory to OHS for a modified Bentall procedure. A change in my personal situation prompts me to ask for help.

My medical condition is bi-leaflet aortic valve (fused and proloapsed cusps) with a dilated aortic root (at the moment, 4.8 cm). To keep my heart strong, I swim 40-50 minutes three times a week. I get an MRA and ultrasound once a year at the Bluhm Cardiovascular Institute (Northwestern Memorial Hospital) in Chicago. So far, the aortic dilation has been stable and hasn't grown for three years, although when this all began around 10 years ago, the measurement was 4.2.

While I've been very pleased with the care and attention I've received at Bluhm, my personal situation will be changing in the near future. That is, I'm moving to western Kansas, so I'll need to find a new cardiologist and thoracic surgeon. Presumably I'll go to the University of Kansas Hospital, which U.S. News & World Report ranks #24 for cardiology and heart surgery. Frankly, that choice doesn't look very good when you've been visiting a top-10 care center. There's also St. Luke's Hospital, which is ranked even lower.

Of course I realize a surgeon's experience and skill is the most important priority and consideration, so I'd like to get some advice and/or recommendations from anyone who has first-hand experience at one of these Kansas hospitals.

Thanks in advance to all who respond!

TH
I live in Kansas City. St. Lukes is rated only 2 points less than KU Med Center in USN, thus their ratings are essentially the same.

I had a bicuspid valve replaced by Keith Allen at St. Lukes. He was picked by being the next guy in line. He does clinical trials as part of St. Lukes teaching mission. I like St. Lukes and believe they gave me the best care possible in their cardiology and heart surgery groups. My cardiologist is Dr. Orme in the St. Lukes group.

I've had 5 operations at St. Lukes and they have saved my life twice (heart and colon surgery, 2 hernias, TURP). I have a GP, urologist, nephrologist, nuerologist, two ortopedists, all from St. Lukes. I go to KU for my sleep apnea because I had a bad experience with the group at St. Lukes, so I'm not a "fan boy". I'm from MO now, state motto "Show Me." :)

KU Med Center is a very good hospital, but early on its cardio program it had some severe problems in the heart and transplant program that were scandalous. The transplant program was stopped. Their program was revamped by a group of doctors that left St. Luke's and the transplant program was restarted (this is probably 20 year old history). It's an excellent program now and I know of many satisfied patients. KC is blessed to have two competing major hospitals.

I use KU Med Center for my sleep apnea treatment, but all of the rest of my care has been with St. Lukes since 1979. For heart issues, I see the two hospitals as equivalent. In other disciplines, one may have the edge over the other. KU has recently expanded and is probably bigger now.

I discussed the two heart programs with my ultrasound technician last week and he thought both hospitals were equivalent, but he'd use St. Lukes just because of intangibles. I really like the fact that St. Lukes is a not-for-profit teaching hospital that's independent and has a Malcolm Baldridge Award-winning quality system in the hospital. (I work in "quality.") KU is a state facility and a university hospital.
 

Debster

Well-known member
Joined
Jul 8, 2005
Messages
547
Location
Louisburg, Kansas
I live south of Kansas City. My mom had her surgery and cardiologist out of Menorah Medical Center In Overland Park outside of KC)-very good surgeon and care there. Between the two hospitals-I personally would choose St Lukes over KU Med for cardiac care. Basically for the reasons Tom has stated. My husband is from Western Kansas-when he was growing up the hospitals in Denver were closer to him than Kansas City... My mom did go once to a ST Lukes doctor who was a pacemaker specialist when she was having issues-he was excellent.
 

tom in MO

Well-known member
Joined
Jan 17, 2012
Messages
999
Location
MO USA
Actually, I'm moving to Dorothy's state-recognized hometown. o_O
Actually Kansas in the Wizard of Oz is based upon Frank Baum's experiences in South Dakota. I don't think he ever lived in KS. Kansas is desperate to give tourists reasons to stop, thus they pretend....But then Australia is Oz right? ;)
 

thos_huxley

Member
Joined
Nov 2, 2018
Messages
5
Location
Illinois USA
I live south of Kansas City. My mom had her surgery and cardiologist out of Menorah Medical Center In Overland Park outside of KC)-very good surgeon and care there. Between the two hospitals-I personally would choose St Lukes over KU Med for cardiac care. Basically for the reasons Tom has stated. My husband is from Western Kansas-when he was growing up the hospitals in Denver were closer to him than Kansas City... My mom did go once to a ST Lukes doctor who was a pacemaker specialist when she was having issues-he was excellent.
Many thanks for the info. I'll look into it!
 

thos_huxley

Member
Joined
Nov 2, 2018
Messages
5
Location
Illinois USA
I live south of Kansas City. My mom had her surgery and cardiologist out of Menorah Medical Center In Overland Park outside of KC)-very good surgeon and care there. Between the two hospitals-I personally would choose St Lukes over KU Med for cardiac care. Basically for the reasons Tom has stated. My husband is from Western Kansas-when he was growing up the hospitals in Denver were closer to him than Kansas City... My mom did go once to a ST Lukes doctor who was a pacemaker specialist when she was having issues-he was excellent.
I hadn't thought about Denver, and I can actually get a direct flight there. I'll check it out!
 

Keithl

Well-known member
Joined
Apr 20, 2019
Messages
177
Pardon me as I get on my soap box... if you can afford it go to Cleveland Clinic. They are #1 for 23 years for a reason. I live in Atlanta and knew I was not going to let these unranked butchers crack me open. If Cleveland is in network for your insurance (it was with mine) then you just pay for travel and lodging for about 7 days. If you search my posts you will see my experience 11 weeks ago.
 

vitdoc

Active member
Joined
Apr 16, 2017
Messages
37
Location
Southern Ca.
The most important decision is the surgeon. The second is the hospital. You want to go to a place and surgeon that does a lot of whatever you are having.
The post op nursing is important the post op intensive care unit is important. So places like Mayo, Cleveland Clinic generally have high volumes with overall good results. Cardiac surgery is a very demanding field with the training very arduous. Years ago it was more in demand than today as a choice for medical students. So probably the overall quality of surgeons has I think dropped a bit. The types of procedures have been whittled down by other alternatives such as stenting reducing bypass surgery and now procedures like TAVR reducing the number of aortic valve surgeries. So a place with a high volume will have people with the most experience. Personally my first surgery in 1977 was with Norman Shumway at Stanford for AVR, In 1983 at Texas Heart with Denton Cooley repeat AVR, and 2006 with Joseph Coselli at Texas Heart for aortic aneurysm and repeat AVR. At the time I had these those places and those surgeons had very large volumes and experiences.
With time things change so today I would look at Cleveland Clinic and a few other places. Sometimes there are places that have specific expertise such as mitral surgery at Mt. Sinai in New York. When I had my last surgery nobody was eager to operate on me due to the scarring from the two previous surgeries. So the local cardiac surgeons encouraged me to go to a place that sees a lot of tough cases. When you have aortic aneurysm surgery your brain is placed in a hypothermic state. The shorter the better. So someone with skill and a good team will likely keep you in that state for a shorter time.
So look around. I think the rankings are not extremely useful. Probably the rankings would be better if they had perhaps three tiers. Two points between two hospitals is not significant.
 

Keithl

Well-known member
Joined
Apr 20, 2019
Messages
177
With time things change so today I would look at Cleveland Clinic and a few other places. Sometimes there are places that have specific expertise such as mitral surgery at Mt. Sinai in New York. When I had my last surgery nobody was eager to operate on me due to the scarring from the two previous surgeries. So the local cardiac surgeons encouraged me to go to a place that sees a lot of tough cases. When you have aortic aneurysm surgery your brain is placed in a hypothermic state. The shorter the better. So someone with skill and a good team will likely keep you in that state for a shorter time.
So look around. I think the rankings are not extremely useful. Probably the rankings would be better if they had perhaps three tiers. Two points between two hospitals is not significant.
Part of why I went to Cleveland is they do high volumes, low issues. Also they do a lot of the harder cases, my surgeon specialized in heart/lung transplants so my AVR and Aneurysm was a piece of cake for him. And to me a great doctor at a not so great hospital is not worth it. The surgeon work son you for a few hours the prep and recovery is all the hospital so I place hospital and surgeon as equally important.
 

Bikes!

New member
Joined
Aug 29, 2018
Messages
3
Location
Nevada
I would focus on who is the best, not who is the closest. As tough as it is, look at mortality rates in the hospital that you are considering. I researched who the top surgeons and hospitals were, then crosss referenced it to who my insurance covered. Thankfully United Health care’s network is nationwide. The Cleveland Clinic was covered, and I was able to get Dr Svennson as my surgeon (thoracic aortic aneurysm with valve reimplantation)
The major hospitals have hotels on campus, so it was easy for my wife to stay there as I traveled from Nevada.
 

Agian

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Joined
Jun 10, 2013
Messages
2,118
Location
Adelaide, South Australia
There are surgeons who are well known for their skill. Look them up, ask around. Get an appointment. Eventually you'll find someone who you're comfortable with. Ask where they operate. Check out the hospital. Talk to the staff.

We get three quotes when we need a fence. I must admit I saw a number of cardiologists, until I found someone who I believed knew what they were talking about. I settled on the second surgeon I met. The cardiologists here are a strange breed. They're always bickering and some of them seem to dislike each other. Quite entertaining.
 

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