You are 66 and your family doctor has recommended heart surgery. All signs point to the need for such an operation. He recommends three possible surgeons. Fine. But who would be most skilled?

The Harvard Heart Letter, published by the Harvard Medical School, in its latest issue notes when you’re shopping for a new car, information on a variety of topics from price to gas mileage is available.

But, when it comes to your heart, how do you know who is the most able and successful heart surgeon? Each year, 500,0000 people, predominantly seniors, die of heart disease. Public agencies have tried to meet the public need and demand for guiding information. But available information is often too complex for public understanding.

Dr. Karen Donelan, senior survey scientist from Harvard-associated Massachusetts General Hospital, was lead author of a study to make sense of the factors that would help a patient determine who will be most likely to operate successfully on them.

The objective: to make information on complications and death rates from coronary artery bypass grafting (CABG) procedures available to the public. Dr. Lawrence A. Cohn, an experienced heart surgeon at Brigham and Women’s Hospital and a professor of surgery at Harvard Medical School was among those enlisted to help determine what information should be presented and how.

The researchers discovered that for patients to determine correctly which surgeon is best varied considerably depending on the format. Some liked numbers in a table. Some liked graphs with color and bars. Others were better with proportions, rates, and measurements, Donelan said.

The researchers found that the ability to correctly interpret which surgeon was best varied between 16 and 66 percent, depending on the format. Not surprisingly, they found that most people, in picking a surgeon, want information on others’ experiences with care, including a surgeon’s interpersonal skills, in addition to objective measurements.

Also, people didn’t understand the concept used in the graphs of the term “risk-adjusted mortality,” for example. Few people would.

“Sick people are referred to tertiary hospitals because they are very sick people and they may be too complicated for community hospitals to handle,” Dr. Donelan said. Sick people are at higher risk for poor surgical outcomes.

Dr. Cohn’s advice: “Ask your cardiologist about your individual risk of death or complication from surgery. It will be based on many factors, including your age, the urgency of the situation, how well your heart functions, the quality of your vessels, and any other serious medical issues you may have."

If you are at increased risk, you need the type of sophisticated, comprehensive medical care available at big medical centers. The hospital you choose should provide care for multiple organ failure and have critical care intensivists in the hospital around the clock. You want full support services, since you could develop kidney failure and need dialysis, which a community hospital may not have.

For data on choosing a surgeon to be most useful, the information has to be presented in a way that can be easily understood. Dr. Donelan and a team of other researchers created a survey with data presented in four different formats. Each format included information on three to five fictitious surgeons and included the number of CABGs performed, patient deaths during the operation, expected patient mortality, and risk-adjusted mortality.

Dr. Andrew Eisenhauer, a cardiologist with Brigham and Women’s Hospital advises, “Make sure you are comfortable with the surgeon’s personality. Some people believe a surgeon should be aloof and demanding. Others feel more comfortable with a warmer style. You need to be on the same wavelength."

Also it’s okay to ask the surgeon, “If you weren’t doing my surgery, who would you send me to? Don’t be confrontational. You are only asking for a fact.” Dr. Cohn also counsels: “It’s perfectly reasonable to ask about the surgeon’s mortality rate for the procedure you are having.”

To further help people make informed choices, the American Society of Thoracic Surgeons (ASTS) has made its members’ statistics available.

Each day, thousands of people in the U.S. have heart surgery. Surgeries may be used to:

• Repair or replace the valves that control blood flow through the heart's chambers.
• Bypass or widen blocked or narrowed arteries to the heart.
• Repair aneurysms, or bulges in the aorta, which can be deadly if they burst.
• Implant devices to regulate heart rhythms.
• Destroy small amounts of tissue that disturb electrical flow through the heart.
• Make channels in the heart muscle to allow blood from a heart chamber directly into the
  heart muscle.
• Boost the heart's pumping power with muscles taken from the back or abdomen.
• Replace the damaged heart with a heart from a donor.

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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