With lightning speed, cardiac care has undergone a dramatic upheaval in the last decade. From angioplasty and stents to keep coronary arteries open, to pacemakers and defibrillators, patients face a dazzling array of less-invasive options to care for their hearts, extend their lives, and promote their quality of life. Although angioplasty and stents are often chosen as an alternative to surgery for plaque clogged arteries, there is increasing discussion in the medical community that bypass surgery should also be discussed in complex cases. When surgery is necessary – whether it is a bypass or a valve replacement, or a combination of both – consumers need to be aware of important considerations for a successful operation and recovery. The cardiac team at Deborah Heart and Lung Center urges patients to shop around and compare when they are considering open-heart surgery options.

What is the Hospital’s Experience?
It cannot be stressed enough that experience matters. The more open-heart procedures a doctor and hospital have performed, the better they will be. It is true – practice makes perfect. Surgeons and surgery teams that have worked together for years with high volume case loads have the experience to anticipate potential problems in the OR before the problems manifest. Deborah Heart and Lung Center urges patients to question their surgeons, and ask, “How many open heart procedures did you perform last year?” “What type of procedures were they?” and “How many did the hospital do overall?” If you’re not satisfied with what you hear, don’t be afraid to shop around. After all, where you have your cardiac procedure is your choice. Dr. Lynn McGrath, Chief of Surgery at Deborah, recognizes the critical relationship between cardiac surgery volume and quality. With more than 10,000 open-heart surgery procedures to his credit, he is one of the most experienced heart surgeons in the world. He alsorecognizes that respect and collaboration between cardiologists, interventionalists, and cardiac surgeons are paramount to crafting the most appropriate treatment strategy for patients. “There is no doubt that more and more hospitals are shifting their resources into cath-lab procedures like angioplasty. Reimbursement is good and it’s less risky,” he said. “The problem these cardiac hospitals run into is that they continue to do open heart surgery without a full commitment to the program. Their numbers start to slip, their experience erodes, both as individual cardiac surgeons and within their team, and the quality of surgery may not be as high.” Dr. McGrath adds that patients should also ask how many years a surgeon has been at a hospital, what type of capital improvements the hospital has made in the OR, and the extent to which the facility is involved in research. Cardiac surgery volume, participation in cardiovascular research, and facility improvements in equipment, personnel, and structure often indicate a hospital’s commitment to its surgery program.

What is the Hospital’s Overall Performance Record?
Cardiac hospitals throughout the state are ranked by many different organizations. These include New Jersey’s Department of Health, the American Heart Association, survey and research groups, and private consumer groups such as Leapfrog. These organizations look at various quality indicators throughout the hospital in their reports. Some look at infection rates, others scrutinize adherence to established guidelines for care, some categorize overall program quality, and others look at consumer satisfaction rates. All of these are critical when considering a hospital for open-heart surgery. “Patients should strongly consider good surgery outcomes when selecting a hospital, but there are additional factors to consider as well,” points out Dr. Augustine Agocha, Chairman of Deborah’s Cardiology Program. “Infection rates are important as well. Even if your heart repair is perfect, you could pick up an infection while you’re recovering. While this can happen anywhere, even under the best of circumstances, a hospital that has known high-infection rates should send up a warning flag to a consumer.”

Look at the Big Picture
 Dr. McGrath noted: “Any time a patient undergoes a surgical procedure, there are risks. An educated consumer should do everything possible to find the best facility. The whole family, not just the patient, is affected by surgery. If all things are equal, look at what amenities the hospital can offer. Is the staff known for its dedication to service? Is the hospital close by, or are family members going to have to drive to a big city, pay parking tolls, and fight traffic? All this puts additional stress and expense on a family.” “We want all patients to be educated consumers. Don’t be afraid to ask.”