Frequently Asked Questions
For Primary Care Doctors: Answers to Frequently Asked Questions.
What Is a Typical Patient Referral Scenario for Heart Surgery?
What typically happens is that a primary care provider finds a heart murmur in a patient and orders an echocardiogram which then shows significant valvular issues. The patient is then referred to a cardiologist who may request another echocardiogram and possibly a heart catheterization to determine the need for surgical intervention. If surgery is needed the patient is referred to a cardiac surgeon.
Why Are Some Patients Better Candidates for Minimally Invasive Surgery vs. Open Heart Surgery?
Any patient who has isolated valvular heart disease (and that’s the only problem, or in some cases a certain combination of problems) is considered to be a minimally invasive candidate until proven otherwise. Patients who’ve had heart surgery before or who have serious heart disease may not be ideal candidates for minimally invasive surgery.
Generally, if a patient wants a less invasive procedure and it can be done as safely as open heart surgery, it’s worth exploring. Benefits include fewer transfusions, a lower infection rate, smaller incisions and faster recovery times. The procedure takes about an hour longer than open heart surgery, but the recovery is much faster.
Why Are Hospitals all Over the Country Sending Their Surgeons to Swedish for Minimally Invasive Heart Surgery Training?
Swedish is one of six minimally invasive heart surgery training sites in the U.S. According to Dr. Glenn Barnhart, Executive Director and Chief, Swedish Cardiac Surgical Services, “We have worked diligently here at Swedish to build a comprehensive training program which involves an entire team approach – that’s one of our successes. We’re a very highly requested training site because we have excellent cardiac anesthesia, perfusion, and surgical techniques with outcomes that are equivalent or superior to a full sternotomy.”
What Is the Patient’s Experience When Comparing Swedish’s Surgery Program vs. One at an Academic Institution?
At Swedish, patients are cared for by a staff that has minimal turnover, which is not always the case at an academic institution that has the expected and usual turnover of residents and fellows. The cardiovascular surgeons at Swedish have extensive experience and training and are complemented by a consistent staff of senior physician assistants with an average 11 years of cardiac surgery experience.
The central focus at Swedish is compassionate, personal care. Starting with an extensive appointment with a cardiovascular surgeon, patients find out everything they need to know about their surgery, particular valve problems, risks, benefits and outcomes. The surgeon’s office is also proactively involved with the patient’s follow-up care after surgery.
Are Patients Well Educated About Minimally Invasive Heart Surgery When They Come in for an Appointment? Do I Need to Advise Them to Do Their Homework About the Surgery?
It’s always good to encourage your patients to learn as much as they can about their heart surgery options. Most patients are fairly well informed and know the questions to ask, such as how many procedures has the surgeon performed, and they usually know the difference between open heart vs. robotic surgery, but not all know exactly what minimally invasive valve surgery means. Here is a good online resource for your patients.
What Are Some Questions My Patients Might Have About Heart Surgery?
- What are the risks? The risks depend on the type of procedure or combined procedures but can include potential for: stroke, infection, bleeding, drug reaction, blood transfusion reaction, or an unforeseen event like kidney failure. It also depends on the patient’s risk profile and pre-op morbidity. Primary care providers can help determine a patient’s risk profile using the Society of Thoracic Surgeons’ risk calculator.
- How painful will it be? In most minimally invasive surgery cases, the pain is quite tolerable and some patients even experience no pain at all.
- How long is the recovery? Recovery can range from 4-8 weeks, depending on the type of surgery. Patients of a reasonable age and risk typically take about four weeks to recover from open heart surgery, while minimally invasive surgery patients recover in about 2-4 weeks.
- How do I choose the best surgeon? Talk to your doctor, friends and family or find a heart surgeon at Swedish.
- Is it covered by insurance? Yes. Check with your health plan for complete details.
- See more patient FAQs.
If My Patient Has Bypass Surgery, How Can I Monitor His or Her Care? What Sort of Follow-Up Care Is Important?
Care is coordinated by the cardiac surgeon, nursing and physician assistant staff, as well as the patient’s primary care provider and cardiologist. The patient sees a cardiac surgeon at two weeks for routine post-op care and then again at one month. A letter is typically sent by the surgeon to the patient’s primary care provider; further contact may occur if there’s a condition that relates to the overall care of the patient such as diabetes.
Is It Okay For My Patient to Get a Second Opinion for Heart Surgery?
Absolutely. It’s very important for the patient to trust and feel confident about both the heart surgeon and the heart center. If the patient is uncomfortable, they should seek a second opinion. At the Swedish Heart and Vascular Institute, we’re happy to give second opinions to patients who are considering heart surgery at another hospital. And we support our own patients in seeking another opinion if that will give them additional peace of mind. Learn more about getting a second opinion.
What Are the Advantages of Sending My Patients to the Swedish Heart & Vascular Institute? What Sets Swedish Apart From Other Heart Surgery Competitors?
Swedish is the only place in Seattle that performs:
- robotic heart surgery
- routine and frequent minimally invasive heart surgery
- frequent stentless valve surgery
- total arterial revascularization – using only arteries (not veins) to revascularize the heart.
Swedish is also continuing to develop and adapt the daVinci robot to cardiac surgical procedures and will be expanding that capability over the next two years. Swedish has the unique advantage of already having a mature minimally invasive heart surgery program in place which is absolutely necessary to be able to do the robotic procedure satisfactorily. Swedish cardiac surgeon Dr. Eric Lehr has performed more than 25 robotic heart surgeries at Swedish and more than 300 prior to coming on staff at Swedish in 2011.
What Is Unique About the Swedish Cardiac Team That Doctors Should Know?
Swedish is the highest volume program in the Greater Seattle area performing heart surgery. The long tradition of cardiac surgery at Swedish cannot be under-emphasized because the experience of a heart surgery program is so critical to its overall outcomes.
Cardiac and minimally invasive surgeries at Swedish have an outstanding team approach with tremendous depth and breadth from all levels of care including cardiac surgeons, OR, cardiac anesthesia and ICU.
Our team is extensive and highly specialized:
- 4 dedicated cardiac surgeons
- 8 dedicated full-time cardiac surgery physician assistants, each with an average of 11 year’s experience
- 10 intensivists for ICU who are double-boarded in pulmonary medicine and ICU medicine
- 30 cardiologists who see patients simultaneously so that at any given time the patient is seen by the cardiologist, cardiac surgeon and physician assistant every day. And the office staff has extensive experience with very little turnover. The OR staff also has a huge amount of overall experience.
- 7 board certified cardiac anesthesiologists who are also TEE-certified (Trans-Esophageal Echocardiography) which means they’ve had extensive training, testing and certification which sets them apart from other cardiac anesthesiologists.
Bottom Line, What Are the Most Critical Things for Primary Care Providers to Know When Referring Their Patients to Swedish for Heart Surgery?
- As the highest volume cardiac surgery program in the Greater Seattle area, Swedish has performed more than 46,000 heart surgeries and is known as the go-to cardiac surgery program for high-risk patients.
- Every heart patient at Swedish is a candidate for minimally invasive surgery until proven otherwise. This is important since these patients are less likely to have blood transfusions and benefit from a much faster recovery than traditional open-heart patients. And, the minimally invasive surgery program at Swedish is strategically integrated with our robotic heart surgery program.
- Dedicated cardiac surgeons who specialize in cardiac surgery, and that’s all they do – they do not perform thoracic or vascular surgery.
- Swedish heart surgery patients receive an exceptionally high level of personal care.
What Educational Resources Can I Provide for My Patients?
Swedish has a great one-stop information resource for heart surgery patients. Learn more.
What If My Patient Is Having Surgery at Swedish but Lives Far Away? Are There Affordable Accommodations for Family Members?
Family members will find the Inn at Cherry Hill a reasonably priced option for staying near our First Hill Campus. Learn more about the Inn at Cherry Hill and other neighborhood accommodations.
Where Can My Patient Call for an Appointment?
For a consultation appointment, call Swedish Cardiac Surgery at 206-320-7300. The office is located at 1600 E. Jefferson, Suite 110 in Seattle.