Is aortic valve replacement considered complex?

  I realize that complex heart surgeries should be done at the larger university and similar hospitals, like Cleveland Clinic.  I also know that Cleveland Clinic was ranked #1 for valve replacement surgery.  But, is it necessary to travel that distance (+additional expense) to obtain quality care for valve replacement when one lives in a large metropolitan area anyway.  I don't know for sure how good the doctors are (most say very good), but is valve replacement complex enough to warrant having the surgery performed elsewhere at a major university or clinic?  What is the expected recovery time when one can travel by car or plane to go home if performed away?  I'm meaning straight mechanical valve here, to last the rest of my life, not minimally invasive procedures or Ross.  The success statistics are still not high enough for me on those.  Thanks on any advice you can give me!

[CCF CARDIO MD APS]

Dear Susan,
Good thinking on not going for the newer techniques that simply do not as yet
have the track record of traditional valve replacement surgery.  The recovery time
at the Cleveland Clinic for valve replacement is generally 5-7 days in the hospital
not including the actual surgical day and for young otherwise healthy patients, it
is closer to the 5 than the 7day mark.  Since the Cleveland Clinic serves many
out of town patients, we are very skilled here at doing all the pre-surgical
evaluation and such in one day.  
As for the expertise involved, firstly let me give you an idea of how much training
the cardiovascular surgeon has prior to his being on his/her own in the OR.  After college
there is 4 years of medical school, then about 3 years of general surgical training, then
4 years at the least just to learn coronary artery bypass grafting and some valves and
aorta surgery.  If the surgeon wants to do more subspecialty training say for more valves,
transplant surgery and such this can take another 3 years!  The surgery is highly technical,
requires a well skilled OR team as well as an EXPERIENCED surgeon.  The reason
why I capitalize experience, is that it is of the utmost importance that you know how many
valve surgeries the surgeon has done in his solo career and even better, how many s/he has
done in the year prior to your surgery.  The Cleveland Clinics' 8 or so CV surgeons performed
over 4,000 open heart surgeries in 1997.  It is common sense then Susan that a
surgeon who has perofrmed valve surgeries on a regular basis is more likely to be better
skilled  at just that surgery than say a surgeon that does only 12 valve surgeries a year, and
many more bypasses.  Ultimately it is your decision, I just wanted to give you some ammunition
to make the choice that is in your best interest.  Mind you there is an at home
recovery time of 3-5 weeks that follows your discharge.  Good Luck.
Information provided in the heart forum is intended for general medical informational
purposes only, actual diagnosis and treatment can only be made by your physician(s).