Cardiology post-cardioversion 11/03/16

 

Here's the audio file for the Dr. Steidley cardiology appointment 11/03/16. Let me know if you can or can't open and listen?

https://soundcloud.com/mobileschu/audio-ani-reidley/s-ZfJwX

Ani

How can I help?

Today, I have about 700 documents that I am sifting through copying and sending out to 3 hospitals tomorrow. I also had 3 hour doctors appointment today. I had a three-hour doctor appointment yesterday I had 3 hours of doctor's visits the day before. I don't mean to be boring but, That feels like a FT job for one day for a person whose health is declining. Thank everyone ahead of time who has ever said the words, 'How can I help you?'

Amazing people, those who reach out. You are my Family, kith, kin and you are amazing.

Sometimes, there is too much, so I sum up: too many thoughts in my mind at one time. Cannot hold onto all thoughts that are all A1 Importance. Especially when I can't even hold onto one with stability. Especially when I am tired, or when I'm not mentally ready.

I feel torn. It feels wrong, when time must be divided and given up altogether for 700 pieces of paper (times 3) and getting them out on a UPS or post office time crunch.

Please, often times I just want God damn peace before surgery. I want to say I did things before I get on that surgery table again.

This feeling has busted up my communication with others. We all mean well but, communicating not so easy like it was just 6 months ago. No need to tiptoe in conversations.

On the contrary, please say what must be said, bluntly--including feelings. We might not get another chance for a couple months to discuss it again. So, we all commit to speaking up, right?

Luckily, Emily and I practice non-passive-aggressive communication. We know when we can tease, we always know when or if to smile. We know when there's sarcasm and when there is not. And we know how to support each other without having to say a God damn word. This is peace to me. I want this peace around me, at least in a sort of 1 room radius around the vicinity of me. I want us to treat each other with kit gloves only about logistics. They bore me to death. Be free expressing love and learn today it's kay to do it more often.

The elephant in the room is I can see an hour glass in front of me and can't really help my reactions or emotions completely. Bu tI CAN HELP how I react to those initial reactions.

You are special to me and that's why we still hang out, right? 'Cause we all so cool. Let's be cool.

Standford Docs - need more stats and info

Norman Shumway, MD

Bruce Reitz, MD

Gordon Shumway on A.L.F.

Bruce Reitz and Norman Shumway (died, 2007) perform the first successful heart-lung transplant in 1981 at Stanford Hospital, Stanford School of Medicine.

Wasn't Norman Shumway the Dad in the TV Series, ALF?

Shumway conducted the first adult heart transplant in the United States in 1968. Building on his research at Stanford, Dr. Bruce Reitz performed the first successful heart–lung transplant on Mary Gohlke in 1981 at Stanford Hospital.Bruce

Some of the followinng info was in an article run in March 2016:

In 1980, no human lung transplant had survivedeitz (left) and Norman Shumway (right) perform the first successful heart-lung transplant in 1981 at Stanford Hospital, Stanford School of Medicine. more than 23 days. Anti-rejection drugs used up to that time didn't allow for wound healing. The U.S. Food and Drug Administration had approved a better antirejection drug, cyclosporin A, for heart-transplant patients, but not for other transplant patients.  Stanford had asked the FDA to approve cyclosporin A for heart-lung transplant patients, too — and then waited and waited. Gohlke, increasingly desperate, asked her former boss, the executive editor of the Mesa Tribune, to help. He made calls to then-U.S. Sen. Dennis DeConcini, D-Arizona, and about an hour later the FDA approved the drug for use in heart-lung transplantation at all qualified hospitals. Gohlke received her new heart and lungs — becoming the first patient in the world to undergo a successful heart-lung transplant — and lived for five years with her new organs.

Long-term survival after heart-lung transplantation was first achieved in 1981 at Stanford and a total of 217 heart-lung transplantations had been performed by June 2008. This review summarizes Stanford's cumulative experience with heart-lung transplantation, demonstrates the progress that has been made, and discusses past and persistent problems. Diagnostic tools and treatment options for infectious diseases and rejection have changed and patient survival markedly improved over the almost three decades. Eight patients lived longer than 20 years. Further options to treat infections and strategies to control bronchiolitis obliterans syndrome, the main causes of early and long-term mortality, respectively, are required to achieve routine long-term survival.

STANFORD HEART DOCTORS

Richard-Tien Ha
Heart and lung transplant surgeon
Clinical Assistant Professor, Card/Thor Surgery
300 Pasteur Drive
2nd Floor, Room A260
Stanford, CA 94305
Phone: 650-723-5468

Philip Oyer

Heart transplant surgeon

Roy B. Cohn-Theodore A. Falasco Professor in Cardiothoracic Surgery

• 300 Pasteur Drive
• 2nd Floor, Room A260
• Stanford, CA 94305
• Phone: 650-723-5468

Euan A. Ashley

Cardiologist

Associate Professor of Medicine (Cardiovascular), of Genetics and, by courtesy, of Pathology at the Stanford University Medical Center

300 Pasteur Drive

2nd Floor, Room A260

Stanford, CA 94305

Phone: 650-724-4942

*conducts research on the health benefits of single malt Scotch whisky.

Kiran Kaur Khush, MD, MAS

Cardiologist

Associate Professor of Medicine (Cardiovascular Medicine) at the Stanford University Medical Center

300 Pasteur Drive

2nd Floor, Room A260

Stanford, CA 94305

Phone: 650-723-5468

Dr. Khush’s research focuses on the evaluation and selection of donors for heart transplantation; the pathogenesis of post-transplant complications, including acute rejection and cardiac allograft vasculopathy; and non-invasive diagnosis of post-transplant complications. She currently serves on the Donor Management Task Force—an ad hoc committee appointed by the US Department of Health.

Francois Haddad

Cardiologist

Clinical Assistant Professor, Medicine - Cardiovascular Medicine

300 Pasteur Drive

2nd Floor, Room A260

Stanford, CA 94305

Phone: 650-723-5468

54 5* SHC Patient Reviews, 2015--all sound like: Dr. Haddad is the best we could ever ask for - we love him!

Michael Pham, M.D., M.P.H. Cardiologist

Inquisitive person, 31 publications focused mainly on predictors (gene studies) and rejection/outcomes of heart transplantation. 

Joseph Woo
Cardiothoracic surgeon
Norman E. Shumway Professor and Professor, by courtesy, of Bioengineering and of Surgery
300 Pasteur Drive
2nd Floor, Room A260
Stanford, CA 94305

Phone: 650-724-7500

Journied: 7th grade

Ms. Vermeulan for teaching me useful facts in 7th Grade... 1989, thank you from my living brething heart. I bet we could debate as to whether a heart breathes or beats. We are one neontologistic experiment, called extant homonins. I can't remember if ini 1989 we were still though of as homo sapiens sapiens (Sapiens Two Times. That's right ;) I am glad to have thought of you today. You are imortant to me in the world.  There are captivating updates in science. 
Would you like to share looking through them together, that would be good for me right now. However, there are no expectations attached. Here's the picture that sent me off on a Pat Vermulan, mind-locomotion. (LOL) 


Again, this is a sentiment worth sharing with you at this point in my life. There will be another open heart surgery schduled for me sometime in the near future. Time will tell. And so, I reached out to you, knowing we share some same interests. 

You have an exceptional moment or two today. 

Annalis Whalen
anilmt6@gmail.com  







pH balance is the overall balance between acid and alkali (base) in the human body, as measured by the alkalinity of urine. 

pH Balance is not related to blood

Blood is regulated by a healthy body to a very tight range. When the systems that regulate blood pH fail, you have serious medical problems. These problems show as acidosis or alkalosis. These medical conditions have nothing to do with nutrition, and they are beyond the scope of Foodary.com

pH Balance is not related to ash residues from laboratory tests

Part of the process of compiling nutrition charts is to incinerate food or drink until all water and organic material is removed. The resulting ash is measured for pH. This is nothing to do with the nutrition value of food, and it has nothing to do with the alkalizing effect of food.

PRAL (Potential Renal Acid Load). This is a scientific standard for estimating the acid or alkaline effect of food.

There is an alternative calculation, NEAP, that may interest scientists.

When we consume food, our bodies perform a series of complicated biochemical processes to try and balance our nutrition needs. All this activity involves acid and alkaline substances. For the best general health, the overall net activity should be alkaline.  the lower you get the total daily score, the better. Aim for around 25% of your calorie intake as acid forming (positive PRAL Score). For a 2000 calorie diet, your total PRAL score should be at most -35. 

You can see that protein is always acid forming, so plan your meal with 150 calories of your favorite protein. Add vegetables, whole grains and fruit to make a 600 calorie meal. If the total is not below -11, switch to more alkaline foods.

If you need any more help to understand my PRAL pH Balance, refer to a book, a food factory, or website. 

-Auntie Ani

-Anutty Ani

Spirit Mom

Heart/Lung Transplant Hospitals Covered Under Our Insurance & Part of The Institution of Excellence

1.     Keck Hospital of USC 1500 San Pablo Los Angeles, CA 90033 (323) 442-8500 Adult : Heart Heart/Lung Kidney Liver Lung

2.     Lucile Salter Packard Children’s Hospital at Stanford 725 Welch Road Palo Alto, CA 94304 (650) 497-8000 Pediatric : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver

3.     Stanford Hospital and Clinics 300 Pasteur Drive Palo Alto, CA 94304 (650) 498-3333 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung

4.     UCLA Medical Center 10833 Le Conte Avenue Los Angeles, CA 90095 (310) 825-9111 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Intestine Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

5.     UCSF Medical Center 505 Parnassus Avenue San Francisco, CA 94117 (415) 476-1000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

6.     Mayo Clinic Florida ** NON PAR FOR HMO/NAP/AWCA PRODUCTS ** 4500 San Pablo Road Jacksonville, FL 32224 (904) 953-2000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

7.     Johns Hopkins Hospital 600 North Wolfe Street Baltimore, MD 21287 (410) 955-5000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Liver Lung Pediatric

8.     Children’s Hospital - Boston 300 Longwood Avenue Boston, MA 02115-5724 (617) 735-6000 Pediatric : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Intestine Kidney Liver Lung

9.     University of Minnesota Medical Center 420 Delaware Street Southeast Minneapolis, MN 55455 (612) 273-3000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

10. Barnes-Jewish Hospital 1 Barnes-Jewish Hospital Plaza St. Louis, MO 63110 (314) 362-5000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung

11. New York Presbyterian Hospital - Columbia 622 West 168th Street New York, NY 10032 (212) 305-2500 Adult : Heart Heart/Lung Intestine Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

12. Duke University Hospital 2301 Erwin Road Durham, NC 27710 (919) 684-8111 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

13. Cleveland Clinic Foundation Transplant Center A110 9500 Euclid Avenue Cleveland, OH 44195 (216) 444-2200 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Intestine Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

14. Hospital of University of Pennsylvania (HUP) 3400 Spruce Street Philadelphia, PA 19104-4204 (215) 662-4000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

15. Temple University Hospital Temple University Health System 3401 North Broad Street Philadelphia, PA 19140 (215) 221-2000 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/L

16. UPMC Presbyterian Shadyside 200 Lothrop Street Pittsburgh, PA 15213 (412) 647-2345 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Intestine Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney

17. Houston Methodist Hospital 6565 Fannin Street Houston, TX 77030 (713) 790-2485 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Kidney Liver Lung Pancreas Pancreas after Kidney Simultaneous Pancreas Kidney No contracted ER Dr's at facility. No contracted Anesthesiologists at facility. No contracted Pathologists at facility. No contracted Radiologists at facility.

18. William P. Clements Jr. University Hospital 6201 Harry Hines Blvd. Dallas, TX 75390 (214) 645-5555 Adult : Bone Marrow Transplant - Allo Bone Marrow Transplant - Auto Heart Heart/Lung Lung No contracted ER Dr's at facility. No contracted Anesthesiologists at facility. No contracted Neonatologists at facility. No contracted Pathologists at facility. No contracted Radiologists at facility.

Is Heart Failure as Bad as it Sounds?

Q: What is Heart Failure, does it mean the heart is not working anymore?
A: Heart failure is a scary term. It does not mean the heart is about to stop working in the next minute. It does mean the heart is not working normally and without treatment will, eventually stop working. There are numerous treatments for heart failure including medications, lifestyle changes and surgery. Some symptoms of heart failure include swelling in the feet, knees, pelvis, abdomen or face; feeling tired and/or irritable; shortness of breath due to fluid in the lungs; coughing; wheezing; and chest pain.

UPDATE: On 1/28/16 Cardiologist, D. Yu of Honor Health, said I do not have to go into the hospital today, or this week even. We are starting on lasix and potassium to alleviate the leg swelling and keep electrolytes balanced. The heart is not enlarged due to heart failure, I have a larger than normal heart. There doesn't seem to be much change from my last echocardiogram, October 2015. The heart and kidney's are functioning well and should handle the new medications well. Liver is a little swollen. We will see this week, how the body takes to the new medications. They should make the swelling go down, making it easier to breathe. 

Emily and I will take daily weight, heart rate, blood pressure, O2 saturation. This data will indicate how the meds are working. We will bring them in to Yu's office Monday. He's on 3rd Street and Dunlap. I have a full follow up scheduled for Friday with him and my new General Doctor, Heather O'Toole. She is on Missouri and 7th Street. Convenient, eh?

Overall when it's time for surgery, I should be strong enough to win that side of the battle. The question remains,what does everything look inside? How much scar tissue is present around the aorta? The answer is based on how many times it has already been operated on. No one knows until they open me up.

The focus my whole life has been on the aorta and aortic valve, seen here in the pretty golden color.

My left side of the heart, where the aorta is, looks like it is doing well, but the right side is showing some issues they will monitor. Heart failure can happen in two ways, systolic (sis TAL ik) and diastolic (die a STAL ik) . Systolic heart failure simply means that your heart muscle is weaker than normal. The heart muscle cannot contract or pump blood as well. The amount of blood that pumps out of the heart with each beat is called the ejection fraction or (EF) and normal is 50 to 55%. With systolic heart failure the ejection fraction is below 50%. Diastolic dysfunction is present when the lower chambers of your heart or ventricles become stiff. The stiff muscle cannot relax between contractions, which keeps the bottom chambers of the heart from filling with enough blood.

Here are some animations. They are awesome, smart and can say a thousands words to help you understand what's going on:
http://www.neheart.com/connect-learn-interact/question-for-your-md/

Heart Valve Animation
https://youtu.be/2jPTt23lRB8?list=UUU8WxNDk0aAmg7726cl3iNg

Aortic Valve Surgery Animation:
https://youtu.be/Nae1hWRGpPQ

How to choose a Hospital for Aortic Valve Surgery

This is no longer a relevant post for my health journey, but a very effective article on finding an AVR hospital. Left up for whomever may need its benefits.

The Original Website:

http://www.consumerreports.org/cro/magazine/2014/08/top-scoring-hospitals-for-heart-surgery/index.htm

6 questions to help you find a heart hospital

 

1. Isn't heart surgery always an emergency? Do I even have time to research hospitals?

If you are having a heart attack, emergency bypass surgery is sometimes necessary. But in most cases heart disease can be stabilized with drugs or simpler procedures, giving you, or a friend or family member, time. Ask your doctor how serious your condition is and how soon you’ll need surgery. Valve disease is serious but rarely an emergency, so you will almost always have time.

2. What should I do if my hospital isn’t rated?

There’s a good chance of that happening, because many hospitals did not share data with us. But almost every hospital reports to the Society of Thoracic Surgeons, even if the information is not public. Some that do report to the STS give similar data to state registries. So ask your surgeon about the hospital’s survival and complication rates. If he or she can’t—or won’t—share it, consider looking elsewhere.

3. What should I do if no top hospitals are in my community?

First, don’t panic. A hospital that gets an average rating still provides good care. If all hospitals in your area get low scores or won’t share their data, you could travel elsewhere. But check with your insurance to make sure the procedure will be covered at the out-of-town hospital. And realize that you might not have as much support from family and friends. If you choose a lower-rated hospital, discuss your concerns about its score with your surgeon. That can be reassuring and help you prepare for your stay.

4. Do I need to go to a famous hospital or one in a large city to get good care?

No. We found top hospitals in bypass and valve surgery in out-of-the-way places. And high-scoring hospitals in one or the other procedure are in all regions of the country.

5. What if my insurer won’t cover the hospital I want?

If you have original Medicare, you should have no problem, because almost all hospitals accept it. With managed care, including Medicare Advantage, you must use providers in the plan’s network or you’re likely to pay all or most of the costs out of your own pocket. If the surgery can be postponed for several months, you could consider switching plans for 2015. That may not be possible if you’re covered through a job, but if you have Medicare Advantage or a plan you bought through a state marketplace, you can switch plans during the annual fall open enrollment period.

6. What if I also want information about my heart surgeon?

That can be difficult to find. We have Ratings for heart surgery groups but not individual doctors. A few states maintain registries for surgeons. (Contact your state’s department of health.) But you probably will need to ask your surgeon for the information you want. If he or she won’t tell you, consider going elsewhere.  

How we rate hospitals on heart surgery

The data come from the Society of Thoracic Surgeons for hospitals that have agreed to share their information with us.

Bypass surgery Ratings

Reflects a hospital’s performance in isolated coronary artery bypass graft surgery, including the open-heart approach and less invasive versions. Overall score is a composite of four measures: survival (percentage of patients who leave the hospital and survive at least 30 days after surgery), complications (percentage of patients who avoid the most serious complications, including needing a second operation, developing a deep chest infection, suffering a stroke or kidney failure, and requiring prolonged ventilation), best surgical technique (percentage of patients who receive at least one graft from an internal mammary artery, located under the breastbone, which improves survival), and right drugs (percentage of patients who receive beta-­blockers before and after surgery to control blood pressure and heart rhythm, aspirin to prevent blood clots, and a drug after surgery to lower LDL (bad) cholesterol).

Valve replacement Ratings

Reflects a hospital’s performance in surgical aortic valve replacement. Does not include data for trans­catheter aortic valve replacement, though the STS has started to collect it. Overall score is a composite of two measures: survival (percentage of patients who leave the hospital and survive at least 30 days after surgery) and complications (percentage of patients who avoid the most serious complications, which are the same as for bypass).

Top-scoring hospitals for heart surgery in USA

Consumer Reports' Ratings of more than 400 hospitals can help you find the right one

Published : June 2014

Last spring, when Zvi Frankel’s grandfather learned that a valve in his heart needed to be replaced, he turned to his grandson for help.

The grandfather, who lives in New York City, had to choose between the standard open-heart surgery and a less invasive, high-tech version. The new option, called trans­catheter aortic valve replacement, was appealing. He wouldn’t have to be placed on a heart-lung machine or have his heart temporarily stopped.

But Frankel and his grandfather wanted to know more. Which worked best long term? Which was safer? And most important, which hospitals and surgeons had the best results? “Doesn’t everyone want to know that when they face something as serious as heart surgery?” Frankel asks.

Well, most people probably do want that information. But, as Frankel found out, getting it is far from easy. In fact, Frankel embarked on what turned into a long quest, ending with him writing an article in JAMA Internal Medicineon how difficult it was for consumers to find needed information.

Along the way he found that many hospitals were eager to talk about the benefits of the new procedure, which involves inserting an artificial valve through an incision in the groin and threading it up an artery to the heart. Several hospitals even promoted it in ads or website videos, such as one we found from New York-Presbyterian hospital in New York City narrated by Mehmet Oz, M.D., director of the hospital’s Cardiovascular Institute.

But the hospitals and surgeons could not or would not tell Frankel what he most wanted to know. It took weeks poring over medical journals to learn that the limited research to date suggests that although the procedure can be the only option for some very sick people, it may be more likely than the traditional approach to cause some serious complications. He found that those ​increased ​risks included the need for a pacemaker and death from aortic regurgitation, triggered when blood leaks around the new valve and back into the heart.

Most difficult was learning how well particular doctors and hospitals performed. In fact, he ended up filing a Freedom of Information Act request with New York state to get success rates for the doctors and hospitals they were considering. Ultimately, his grandfather chose the traditional approach, performed by a surgeon with a good track record at Weill Cornell Medical Center in New York City, according to the data from the state registry. The surgery was a success.

“It shouldn’t be so hard,” says John Santa, M.D., medical director of Consumer Reports Health, who helped Frankel publish his article. “Not everyone has a grandson like Zvi to act as a full-time medical detective. Hospitals and doctors should make the information accessible and understandable, so families can make informed choices when they make life and death decisions.”

Our first ever Ratings of hospitals for heart surgery are an attempt to help you do just that.

Opening up heart data

We rate hospitals on two heart surgeries: surgical aortic valve replacement, the kind chosen by Frankel’s grandfather; and coronary artery bypass graft surgery, an equally serious operation done to treat blocked coronary arteries. (Read more about how to treat heart disease.)

The Ratings are based on the gold standard in tracking hospital performance: data from patients’ medical records showing whether patients survived the procedure and how they fared on other important measures, including complications. To create a level playing field, the data are adjusted for the health of patients because certain hospitals treat more older, sicker patients than others.

The information comes from the Society of Thoracic Surgeons (STS), which represents physicians who operate on the heart and other organs in the chest. The STS has collected the data for several decades. More than 1,000 U.S. hospitals report to the STS, but only about 400 allowed the organization to share the data with us.

“All hospitals know this information,” Santa says. “Those that have agreed to share, especially those with low scores, should be applauded for their commitment to transparency. Those that haven’t shared should make it available—otherwise, it seems like they have something to hide.”

What we found

Here are some of our main findings:

• Certain famous hospitals are missing. They aren’t in our Ratings because they don’t share data with us, the STS, or both. That includes two hospitals Frankel’s grandfather considered, Columbia-Presbyterian and Weill Cornell. Also on that list: Cedars-Sinai Medical Center in Los Angeles, Johns Hopkins Hospital in Baltimore, and the Mayo Clinic in Rochester, Minn.
• Top hospitals are in surprising places. Only 15 hospitals in our Ratings earned top scores in heart-valve and bypass surgeries. Although the well-known Cleveland Clinic made the list, so did some less familiar hospitals, such as Borgess Medical Center in Kalamazoo, Mich., and Mother Frances Hospital-Tyler in Tyler, Texas. Some are major medical centers; others are smaller. “It’s not name or location or ad budget that matters; it’s a commitment to quality, and that can happen anywhere,” Santa says.
• Performance varies widely, even at neighboring hospitals. We found four metro­politan areas—Indianapolis, Los Angeles, Oklahoma City, and Portland, Ore.—where there are top- and low-scoring hospitals, sometimes just miles apart. “In those communities, the hospital you choose can really make a difference,” Santa says.
• Many hospitals do a good job. Of the hospitals that shared their bypass data with us, 20 percent (83) were above average, 75 percent (310) were average, and 4 percent (18) were below average. The STS has high standards, so hospitals with average scores still do a very good job, says Robbin Cohen, M.D., an associate professor of cardiothoracic surgery at the Keck School of Medicine at the University of Southern California and a member of the STS. Of the 247 hospitals with data on valve surgery, 10 percent (25) got a top score, 87 percent (216) a middle score, and 2 percent (6) the lowest one.
• 
  

• Top-scoring hospitals for heart surgery

  Only 15 of the hospitals that share their data with us earned top marks in bypass and valve surgeries ­(listed alphabetically)€:
• • Baystate Medical Center, Springfield, Mass.
  • Borgess Medical Center, Kalamazoo, Mich.
  • Cleveland Clinic, Cleveland
  • The Heart Hospital Baylor Plano, Plano, Texas
  • Kaiser Permanente Sunnyside Medical Center, Clackamas, Ore.
  • Kaleida Health (Gates Vascular Institute at
    Buffalo General Medical Center), Buffalo, N.Y.
  • Mother Frances Hospital-Tyler, Tyler, Texas
  • St. Joseph Mercy Hospital, Ypsilanti, Mich.
  • St. Joseph’s Hospital Health Center, Syracuse, N.Y.
  • St. Vincent Heart Center of Indiana, Indianapolis
  • Sequoia Hospital, Redwood City, Calif.
  • Spectrum Health - Grand Rapids (Meijer
    Heart Center), Grand Rapids, Mich.
  • Swedish Medical Center-Cherry Hill Campus, Seattle
  • UMass Memorial Medical Center, Worcester, Mass.
  • Valley Hospital, Ridgewood, N.J.

The risks of heart surgery

Aortic valve replacement is mostly done when the valve in the heart’s left chamber accumulates calcium deposits, obstructing blood flow. Over time, the heart fails as it struggles to keep blood pumping.

Even in the hands of skilled surgeons at good hospitals, the procedures can sometimes lead to heart attack, kidney failure, or other problems. After surgery, patients are put on a ventilator, which increases the risk of complications, including pneumonia and other infections.

“No surgeon and no hospital can do heart surgery with zero complications and zero deaths,” Cohen says. “Patients undergo heart surgery because the benefits outweigh the risks.” But as our Ratings show, results vary among hospitals. So which hospital you choose matters.

Frankel ultimately got enough information to make a decision, but he says that efforts such as our new heart Ratings would have helped. When confronting surgery, people need to know they are making a decision based on facts, Frankel says. “You can choose the best doctor and best hospital, and you still may not have positive results,” he says. “But people should be able to know they did everything they possibly could.”